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i <br /> ��RMIT APPLIC�lTI��E I <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, V/A 98201 I <br /> 425-257-8810 — I AX 425-257-'d857 i <br /> SITE ADDRESS PARCEL'�AX I.D. # • PeRMl7� I <br /> �08 34nt ST ho?-�7-c�� <br /> LEGAL LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADDFiESS ZIP PHONE <br /> �/ G' J a��-�c,�y r/�ns s�3 �j4W�s sL.i�s i��s g81s� ��ZS�11I9 -Dyoti <br /> TENANT NA�dE <br /> CONTACTNAME PHONE <br /> ADDRESS ZIP C0�4TR.IICENSE u � <br /> CONTRACTOR �g�NSuN A�,,,�I� �,✓L- � <br /> 14d3u /1S�rt/ Qv� .�[-.� ��u3 QOFj.wp�Kz7uLl <br /> PHONE L3bJ� �J�i ' 71�Z l3-�2c.��vG/'7J1� <br /> PROPOSED USE OF BUIL�I�JG Building Mechanical Addit:�n HEAT SOURCE <br /> PEFMIT Combinalion R Plumbing WORK R Alteration � Eleclric <br /> TYPE emolition D Sign TYPE R New Gas <br /> Sprinkler LJ RopairlMninl. Other <br /> CONTRACT PRICE JF WORK � 15�G CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> �.�5 rFtr� .=./lr s P,¢�uLc.L'x s ys7L�Yvi �.� ,vc"�-- s r—� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET _ NC-A/HANDUNG UPJITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATCRY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK& DISPOSAI _ CLOTHES DRYER <br /> DISI-iW,vSHER _ RANGE HOOD <br /> LAUNDRY TRAY _ WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPtACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER __ _ �THER <br /> — a[� _C�2 i�vK Lc'� /1T�s <br /> I HEREBY CEFITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAh7E TO BE TRUE AND CORRECT. ALl <br /> PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS Tl'PE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR I <br /> fJOT. THE GRANTING OF A PERMIT DOES NOT PFESUh1E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL lAW REGUI.ATING CONSTRUCTION OR THE PERFURMANCE OF CONSTRUCTIGN. THAT I AM AUTHORIZED BY THE I <br /> OWNEA OF THIS PROPERTY TO PERFORM THE WORK FOR SNIiICH APPLICATION IS M11ADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 R AND 296. 00 WAC. / <br /> � �3 /iJ Z � <br /> Signawr f Owne Contractor/Authonzed Ageit Date �/l I <br /> I <br /> — I <br />