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P�RMIT APPLICATI�nI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADDRESS �� PARCEL TAX I.D.8 PE T# <br /> `f0.3 �fBT�f�,. SE�� 01 � `���'L�' <br /> LEGi+ LOT NO. BLOCK TRACT <br /> �esc. l,Up!' oFSE Q/RoF/+dT3 Tw A .RASEA <br /> OWNER ADDRESS ZI HO E <br /> �i'�itiwg� �b,- T� {?v•r3ox a7� !"u��,e� �8ae6 �.�o -�3 <br /> TENANTNAM I CONTACTFORPERMIT PHONE <br /> ��n t�Ni�y��.., �'�S'-3y�-�Sa.2. Ggu� <br /> CONTRACTOR ADDRESS ZIP CONTR.UCEN9Ei <br /> r-`�fiK�E� �ysT. ��� , j?a ,�Dc q76 ��rekll 9�Pao6 <br /> PHONE � /�� Pff�HHcro�oa� <br /> �.�C'-3�f8'-dSolol _ <br /> PROPOSED USE OF BUILDING � B�ing Mechanica Additlon NEAT 80URCE <br /> PERMIT 11yCombination R Plumbing WORK � F�M2tlon � <br /> �r^ � ���`� rrPe D Demolition D Sign TYPE D�ew Gan <br /> ��/�f(a iE D Sprinkler D RepaidMaint. Other <br /> CONTRACT PRICE OF WO �� QQ� //�/���� — CITY OF EVERETT IOCAL SALEE TAX CODE IS 7103 <br /> L <br /> WORK DESCRIPTION � <br /> N/""r.cV Si�G/� �,9lh�u-� �i�cS�,D�i+t�-1� �j � <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. . TYPE OF FI%iURE OR ITEM <br /> �_ WATER CLOSET{TOILET) / AIC—AIHANDLING 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 1_ RANGE HOOD <br /> LAUNDRYTRAY � WATERHEATER <br /> I CLOTHES WASHER _L METAL FIREPLACE/STOVE <br /> URINAL FIREFLACE INSERT <br /> DRINKING FOUNTAIN Z GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER � GAS PIPING <br /> SINK(SERVICE/BARIMOP/ETC.) .� � EXHAUST FAN l/I/ <br /> OTHER OTHER <br /> I HER[:3Y CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AN�ORIDiNACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPEC!rIE�HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORiTY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE O CAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE <br /> OWNE F HIS PROPER R WORK FOR tNHICH APPL!CA770N IS MADE AND I COMPLY WITH THE STATE <br /> CONT CT RS 1B 7 RCW AND 2 20 WAC. <br /> Sig of O�ened ctodA thonze t e <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED /L <br />