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� M c Jnlo' 33�� <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE�T, EVERETT, WA 98201 <br /> 425-257-8810 -FAX 425-257-8857 <br /> SITE ADDRESS L V� !� � ` PARCEL TAX I.D.It PERMIT� <br /> �� � I 0 � �C )I'�� l�G ��l`�`�C71 �( J�'� - ClD �� <br /> LEGAL LOTNO. BLOCKr'��� TRACT <br /> DESC. � `-(�j � �(���) I <br /> OWNER ADDRESS LP PMONE <br /> ;'ii��� i;( � V�% f�{� i�n : � I/:, �l'' � - � � '"'_ �' Iv/� �'f`�201 ��25 � 'LS �7 ^` ,I <br /> DC <br /> TENAAT NAME CONTACT FOR PERMIT PHONE <br /> (Uin;� ��;:� c�. Crt;ti�n, c/c� ?,o(n 3(�7� � (a'Zcl o <br /> y'_t�z�s� rn�,li �,� 5 F����f�� �� ` �r�t.;, ; ,:, [.✓�r�!,� c � " <br /> CONTRACTOR AODRESS ZIP CONTR.LICENSE N <br /> 111 �,, f� , � � ., �+r�,t.. ,�, , , � I(n +,^ J�.���� � �">? 1 i UI'lIVl1''� - <br /> PHONE J � J�L "�r � � <br /> 7o(c %�in�d '- '�+Y� . <br /> PROPOSEDUSEOFBUILDING � Building � Mechanical Addition HEATSOURCE <br /> :_,Ij�-� i .-� � t_ i�p �•. ! J PERMIT Combination Plumbing IWORK R Allcration I � Elecldc <br /> TYPE Demolition Sign 7YPE �� Nnw Gas <br /> ��(' �. '�.�r Sprinkler d Ropair/MainL Olher <br /> CONTRACT PRICE OF WORK `{i 3 C�G;� �I�j�f./ � CITY OF EVERETT IOCAL SALES TAX CODE IS�705 <br /> WORKDESCRIPTION q �1 :��i'� �'' r' C � �/"��i'�' ` ^-1 � ( <br /> P�t�l� � r✓�c , �?�� i, . % .�I c'" c�o'� <br /> , _ � .. _ i n � � <br /> ,���1 ' ' . ' . �" : ( (,; � L�� � ,�%��l " ri.,�_.% �. �! i . . , . i�+ .r � (.{ r,'•(%� 1" ✓�';��i� <br /> 1 <br /> � �► G�Ir{�C "� (',:� 't�✓��:�f- c;����c5 . <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> '� WATERCLOSET '� A/C-A/HANDLINGUNITS �/I��('� TEYiN��/"/' <br /> BATHTUB _ FORCEDAIRSYSTEMS � ;r�, �-� ��� <br /> T LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER I UNIT HEATERS <br /> (i KITCHEN SINK 8 DISPOSAL CLUTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> � LAUNDRY TRAY ,� WATER HEATER <br /> � CLOTHES WASHER _ METAL FIREPLACEISTOVE <br /> ' � URINAL _ FIREPLACE INSERT <br /> � ORINKING FOUNTAIN _ GAS FIREPLACE <br /> � FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREV�NTER _ GAS PIPING <br /> � � SINK(SERVIGE/�ARIM.OP/ETC.) EXHAUST FAN <br /> � OTHER 1� 1 ' � - �i.+'7 . � $ `�' ) OTHER f�!r�� kJ S <br /> /. ; i � <br /> � '\� .i � Y'71,;�SVi I�'� ( I/� . <br /> — ' i I� ' . ;:. � Y � ' 7Y _7 <br /> J— �l•f' � �.�r� �f'. �/ �'-� — __ <br /> II HEREBY CERITIFY THAT I HAVE READ AND E�AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CURRECT. ALL <br /> PROVISIONS OF LAIh'S AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A NERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTMER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TI1E PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF iHIS PROPERN TO PERFORM THE WORK FOR bYHICH APPLICATIUN IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS lAW 18.27 RCW ANU 296 200 WAC. <br /> ',�,�,�nnn� �it/L�-,�U/d' 7�(l�-D3 <br /> Si nature of O�mer/ContradodAuthonzed Agent Date <br /> DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> � I, �. �-��, ._ �„ !� ; b- f . ' �., <br /> ;'� � I' <br />