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�- ERMIT �FRLI��T�JN <br /> CITY OF EVERCTT PERMIT SERI/lrES <br /> 3200 CEDAR STREET, EVEHETT, WA 98201 <br /> 425-257-8F310- FAX 425-257-8857 <br /> ITE ADDRESS PARCEL TAX I.D.!: P MIT a <br /> C�� �'��s � _�,� on s vo2soo a f�33�3-�� <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> / � �1 � yzS-�39-?'� <br /> P�L1� ��1n�( l� v7e �!'�i���So�1 j��� J7��,'� �✓f��e,f.t6✓a. ��L�/ <br /> � <br /> TENANTNAME CONTACTNAME PHONE <br /> CONTRACTOR ADDRESS � ZIP CONTR.LICENSE# <br /> ,:,�7a� /��ak �� r�� �os�v%az�f'/� <br /> PHONE v2.7-3l� �� - �PL� J!(-�!1 GJOOC� �i�-/ct. %D �'2'�2 <br /> PROPOSED USE OF BUIL�ING Bui!ding I� Mechanical Addition HEAT SOURCE <br /> PERMIT Combination f-"� Plumbing WORK Alteration tlectric <br /> TYPE Dem0liliCn 4 � <br /> �) Sign TYPE New Gas <br /> Sprinkler RepaidMaint Olher <br /> CONTRACT PRICE OF WOflK 2dJzG - I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCFiiPTION �fiy�c.�C �� �ci��t+�P � �Cf' aCC �"U /!t`�tc/ S'/u C�t!'e' � S�ti'+^-e <br /> -�D h f ri'`..��°`�', Q / <br /> ���,:��� /��'� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM N0. TYPE OF FIXTURE OR REM <br /> WATER CLOSET A/C-A/HANDLING UNiTS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINf(&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GPS FIREPLACE <br /> � FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> _ SINK(SERVICE'BAFUMOP/ETC.1 "p EXHAUST FAN <br /> OTHER �� _ OTHER <br /> — U"�` ��� — <br /> _ � ,�{��i,� — <br /> �Y" <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAIdIMEU THIS APPLICATION AND KNOW THE SAME TO BE TqUE AND CORRECT. ALL <br /> PFOVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF Vv"ORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES YOT PRESUME TO GIVE AUTNORITY TO VIGLATE OR CANCEL THE PFOVISION CF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE FERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OFfiHIS PR�P,ER��-TY���JJJTO PERFORM THE WGaK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTHAC70RS LkVJ�'(8.2y�iC �iJD 295.200 N'A . <br /> �/' / // <br /> �v-i.y/� C�� ���- i/�-�� <br /> Signature of wneriCo'ntractodAuthorized Agent Da e �I� <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />