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��. <br /> i <br /> P RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I ��� 425-257-8810- FAX 425-257-8857 /�,. ) �, /O�� O� <br /> �/W (/`f <br /> SITE ADDRESS� PARCEL TAX I.D.# p�RMIT#�. U �/ <br /> Q�-c� � t 7 <br /> LEGA LOT NO. BLOCK TRACT /�� <br /> DESC. � . S-D � d/'"SiE Wi��/"�+OT3 / ���9� �Q�S�� <br /> OWNER ADDRESS 'LIP pHONE <br /> y�ih�H,Eti � q-. �y�. , .�r „c�,� 97b �?f�.( �f�s=a923-7�7 3 <br /> TENANTNAM CONTACTFORPERMIT PHONE <br /> �LNF' ' '/��'y!G�l `F�CI 'L,Y t) � �V t�a� <br /> CONTF'ACTOR ADDRESS 21P CONTR.LICENSE M <br /> �HNN�� �Nsr, r?o. ,�ox 97�6 q��o�6 r�IHH�Io/o,a� <br /> PHONE <br /> ���- 3��/S�1 /z�l)i��$�r <br /> PROPOSED USE OF BUILDING B ' ing � MeChaniCal qdditlon HEAT SOURCE <br /> ,� PERMIT ombination Plumbing WORK �on EI c <br /> ���� ����L TYPE Demoiition Sign 'fYPE ew s <br /> Sprinkler I RepaidMa(nt Other <br /> CONTRACT PR�CE OP WORK CITY OP EVERETT LOCAL SALES TAX CODC°IS 3105 <br /> WORK DESCRIPTION <br /> �la � a� �� <br /> PLUM8ING MECHANICAL <br /> NO. 'fYPE OF F'IXTURE OR ITEM N0. . TYPE OF FIXTURE OR ITEM <br /> ,� 1VATER CLJSET(TOILET) A/C—A/HANDLING UNITS <br /> � BATHTUB � FORCED AIR SYSTEMS <br /> .,� LAVATORY(WASH BASIN) HEAT PUMP <br /> _� SHOWER UNITHEATERS <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 FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PkEVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY C�RITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACcS GOVERNING THIS TYPE OF WORK WILL BE COMPLItD WITH WFiETHER SPECIFIED 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 LOCAL LAW REG CONSTRUCTION OR THE PERFORMANCE��F CCNSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWN 0 THIS PROPE Y TO PER R E WORK FOR WHICH APPLICATION i�MADE ANi�I COMPLY WITH THE STATE <br /> CO RA �W 1 .27 RCW AND 2 .20 WAC. <br /> �— <br /> namre of OwnedContr thorized A nt Da e � ,�� � <br /> DEBIT& CREDIT CARDS AF�E NOT ACCEPTED <br />