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1 <br /> �'�RMIT A�PLICA�'I�N ; � <br /> CITY OF EVERET'T PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25?-8810 - FAX 4•25-257-8857 <br /> I SITE A�DRESS PARCEL TAX IA. # PERMIT a <br /> 2Ho -39�'�rcc� oos�6003i.�. ��ooil �030.� -o.� �, <br /> LEGA LOT NO. BLOCK TAACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> �� �kee�ef ��a �8�� <br /> TENANT NAME CONTA:f FQR PERMIT PHONE <br /> �/i! , f <br /> CONTRACTOR/ aN e �I4�/�J�y �� AD�RESS �7DOY' �o���fU�(U�,i/ CONTR.LICENSE N <br /> s7�J L Uu f's� �'sl�z9L sPRNE61�ylJa <br /> PH�NE �JL�J��ZLJ'Zl3lS �� <br /> PROPOS USE OF BUILDING Building n Mechanical Addition HEAT SOURCE <br /> �a/ ho $� PERMIT Combination F� Plumbing WOFK Alteration R Electric <br /> TYPE Demolit:on LI Sign TYPE � New �j Gas <br /> Sprinkler Repair/Maint. L� Other <br /> CONTRACT PRICE OF WORK CITY OF EVERE�7 LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCR�PTION ��'b 1_�G� Q (�D �X�� �lj4/k4 Pi <br /> T v i <br /> PLUMBING J�� fJ MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEh1 " /� NO. TYPE OF FIXTURE OR ITEM �� <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 SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIRE°LACE�STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINK�NG FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICJBAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER _ <br /> II I — — — I <br /> I HEREBY CERITIFY THAT I HA'JE READ AND EXAMINED THIS APPLICA�ION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COh1PLIED VJITH WHETHER SPECIFIED HEREIN OR <br /> INOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOWTE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE O OCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE I <br /> I OWNE F P PERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS M4DE AND I COMPLY WITH THE STATE I <br /> CONT S 827 R W AND 296.200 WAC <br /> � Sign wre �ner ont vAu hori�e�gent � Dat�� �/ <br /> I <br /> DEBIT & CFEDIT CARDS AR[ NOT ACCEPTED y� I <br />