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P�ERMIT APPLICATION <br /> CITY QF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> 2��9 3y7`n S�- 6 d�d 3 -oo�, <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT u �— <br /> ���8-38th AVL�nue 00 5?60 023 000 05 �1'e3� <br /> LEGA LOT NO. BLOCK TRACT <br /> oesc. 23 J.S. Sines Acres Tract <br /> OWNER AODRESS 21P PHONE <br /> Greg Tisdel 2118 38th Avenue 98201 (425)258-2391 <br /> TENANTNAME CONTACTNAME PHONE <br /> Same I Gary Parkinson, Architect (425) 252-2153 <br /> CONTRACTOR ADORESS ZIP CONTR.IICENSE M <br /> Gaffney Construction 10511 19th Ave SE Ste C 98208 GAFI'NCI104K3 <br /> PHONE <br /> (425) 338-2114 <br /> PROPOSED USE OF BUILDING Buildi�g Mechanical Addilion HEAT SOURCE <br /> PERMIT Combina�ion R�^ Plumbiny WORK Al�eration X Eleciric <br /> Coor c�i �915C. I.tlfil}J2T TVPE D2rt101i1i0f1 LJ Sig❑ TYPE New � Gas <br /> StoYage Sprinkler RepaiqMaint. U Other <br /> COMTRACT PFICE OF WORK ���'�O CITY OF EVERE7T LOCAL SALES TAX CO�E IS 3105 <br /> WORK DESCRIPTION <br /> Grading and parking for 8 cars, wood pole building construction, metal roof and walls, <br /> concrete floor, small office �aith single rnstroan. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUFE OR REM NO. TYPE OF FIXTURE OR ITEM <br /> � WATERCLOSET _ A/C—AlHANDLINGUNITS <br /> BATHTUB _ FORCcD AIR SYSTEMS <br /> � LAV'�ORY (WASH BASIN) HEAT PUMP <br /> SHC ER �— UNIT H[ATERS <br /> KITCHEN SINK& DISPOSAL C�OTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUND}�Y TRAY WATER HEATER <br /> CLOTH�S WASHER METAL FIREPLACE/STOVE <br /> _ URINAL '� IREPLACE INSERT <br /> — DRINKING FOUNTAW _ �PS FIREPLACE <br /> FLOOR DRAIN _ GEC�RANGE <br /> BACKFLOW PFEVENTER GAS P�PING <br /> SINK (SERVICFJBAR/MOP/ETC.) � EXHAIJST FAN <br /> OTHER OTHER <br /> I HEREBY CEFITIFY THAT I HAVE REA�AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AN�CORRECT. ALL <br /> PROVISIONS OF W WS AND ORIDINACES GOVEFNING THIS NPE OF WOFK 6VILL BE COMPLIED WITH WHETHER SPECIFIED HEPEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE PROVISION OF ANY OTHER <br /> S7ATE OR LOC.1L LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERN TO PERFORM THE WORK FOF WHICH APPLICATION IS MADE AND I COMPL'ti WITH THE STATE <br /> CONTRACTOflS LAW 1827 RCW AND 296.200 WAC. <br /> Signature of OwreuContractodAuthorized Agem <br /> Da�e �� <br /> '�z <br /> � <br />