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/ I <br /> �ERMIT APPLICATION ' <br /> CITY OF EO/ERET7 PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D. # ' PER�nl7 n <br /> �n�- �l� =� 7'c � �i;��--f—� m o - a ; <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> ��-�r���- lc�(a �� i-z,e �07 ��"�� P�- �c�`F-�- �g�) `��s �sa-�s� <br /> TENANT NAME CO�NT'C�T FOR PERMIT PHONE <br /> �.((kL. �� �.� �� �l��3 <br /> C TRACTOR � DRE55 ZIP CONTR.LICENSE# <br /> ����' ���� ' p.o , �� 2s36 <br /> ` �`�,���Y �ugP�',C�k�f87M�i <br /> PF�ONE ��_ �z� �3 !����'��C�� �(�a , <br /> 4'�� <br /> PROPOSED USE OF BUILDING Building Mechanical Additlon HEAT SOURCE <br /> pr- � F� PERMIT RI-( Combination RI-( Plumbing WORK Alteralion �I�ly Electric <br /> L�r��,� �) ( ,.,� f TYPE �.j Demolition fJ Sign IYPE New /�Gas <br /> . � �� U Sprinkler RepaidMaint. . U Other <br /> � <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX C9DE IS 3105 <br /> WORK D[SCRIPTION • <br /> � �C�l{' -e k�r s��� ��ce��e �- GP�.�,,,�"' G(14�; C� <br /> PLUM3ING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OP FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&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 GAS FIr�EPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACF;FLOW PREVENTER GAS PIPINC=• <br /> SINK(SERVICE/E3AR/MOP/ETC.) EXHAUST F�,.; <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE A�1THORIN TO VIOL4TE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CO�TRUCTION OR THE PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY TF1E <br /> OWNER O THIS PROPERTY, 0 RFO THE WORK FOR N;HI�;H APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRA 5 �8.27 � � D 2 a WAC. <br /> i � <br /> . � ����� '�y� � �!'�' �. / —�}r' <br /> � <br /> Sig Atur of OwnedContr A oriz gent Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />