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r— ---- , -- � _. �--� <br /> ���,�' P�.s�MIT �aPP 'L!�/�►T'iC . � ' <br /> I �w�a,.,. CITY JF EVEh�TT P��3MIT SEiRVIGES � <br /> �`"" 3200 CEDAR S" = EET, ENERET7, WA 98201 <br /> � 425-257 9810 - FA,� 425-257-8957 <br /> I <br /> SITE ADURESS PARCEL TAX I.D.# � peprair a <br /> .� l �� �l`�t�� rV'�OZ�j�I-OGZ/_ <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWJFR ADDRESS Z�P PHONE �— I <br /> i i Z /J�o/' <br /> TENANT NAP,7E I CONTACT NAME PHONE I <br /> CONTRACTOR AODRE/55 ZIP CONTR. LICENSE q <br /> E7 H'NE��"7!/ S%- s%'f��T /3rG-7-�� �C�l/ �,/7a9/<�/�/1 (//G-'�t: � i;, <br /> �"3�0/ �G'7?G� SO,:..��C I <br /> � s� - �//y i <br /> PROPOSED USE OF BUILDING Building Mechanical Addition HEA i SOURCE <br /> G��Z� �.i PERh71T R Combinalion�Plumbinc� KORK � Alleralion i) Electric <br /> TYPE D Demolition U Sign TYPE New Gas <br /> ��LI�'��,�jl�,� U Sprinkler Fepair/MainL B Ufher <br /> CONTRACT PRICE OF�IVORK CITY OF EVERETT LUCAL SALES T.AX CODE IS 3'105 <br /> WOflK DESCRIPTION e — <br /> ,y"�v5T�9�c. e-r,5 . �--s�-iv ���� vc7riT ��1-7 r�/�v/Yt � <br /> � <br /> PI_Uiv181NG MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM .Jl:. I TYpE CF FIXTURE OR ITEM <br /> _ WATERCLOSET r'C-A/HANDLIWGUIJITS <br /> _ BATHTUB _ FOi;^ED AIR SYSTEMS <br /> _ LAVATORY (WASH BASIN) HFAT F''.JMP <br /> � _ SHOWER _ U�VIT HE�TERS <br /> � _ KITCHEN SINK 8 DISPOSAL CIO.TNES DP.YER I <br /> I _ DISHWASHER _ FRNGE HOOD <br /> I = LAUTlDRY TRAY = WAT�R HE4TER � <br /> CLOTHeS WASHER PdFTAL FiREPLAC'c/STOVE <br />� URINAL FIREPLACE INSEHT <br /> ( = DRINKING FGUNTAIN = GAo FIF'EPLACE <br /> FIAOR DRAIN GAS FlAt�GE <br /> _ BACI<FLOV�� ?REVENTER GAS PIPING <br /> SINK(SERJICE/BAH/MOP/ETC.) Z EXF+AUST FAN <br /> � _ QTHER_ __ OTHER_, <br /> I <br /> I \� _�_ <br /> I HERFBY CEFITIFY THAT I HAVE READ At� X.4MINED THIS APPlICA710N AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL <br /> I PROVISIONS OF 1A4V5 AND OqIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIcD WITH WHF.7HER uPECIFIED HEREIN OR <br /> � NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AI:THORITY TO VIOLATE OR�ANCEI THE PRUVi51JN OF ANY O7HER <br /> , STATE OR LOCAL LAW HFGUL4TING CONSTRUCTION OF THE PCRFOR�4ANCE OF CONSTRUCTION. THAT I AM P.UTFiORIZEC BY l HE <br />' � OWNER OF�lilS PROPEFIY TO PERFORM THE INQRK FOR WHICri AP?I.IC�4TI0N i5 PAADE AND I COMFLY WITH THE STATE <br /> I i CUNT C[TORS W 78.?7 RCIV AND 296.200 WAC. <br /> � � �`— <br /> ,_ �..���i � <br />, Signalure ol OwnedContra.tor/Authorized Agent �ate <br />