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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> �D� c.�o�-�� <br /> SITE ADDRESS PARCEL TAX I.D.# P RMIT# <br /> �- �rT= a9osa��so�'oo � caS- 3 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. G�S'�� � oFsE iR oF l�OT3 Tw•�l a9 H RfF$dA-. <br /> OWNER ADDRE33 LP PHONE <br /> ����y�� �4s7. �� . Pd� � �9'�6 �vlflZ�i7 RP�3 yas�se.-u�3 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> � d3up �ft�yy�y �s=���,sa�- <br /> �r�NTRACTOR ADDRESS ZIP CONTR.LICENSE M <br /> 7�/�/H�(�� Ksr, f�C�. ,�dh �17.6 `I�O(� t''�/�tia(lo/O t3�1. <br /> PHONE <br /> �f�5-��l�-�Cr�Z �gJ'1.�c77� <br /> � <br /> PROPOSEDUSEOFBUILDING pERM1T Q�Com�b�eation R Piumbingal WORK RepanidMain�, HEATSOecVic <br /> TYPE D Demolition � Sign TYPE ew �G�er <br /> U <br /> CONTRACT PRICE OF VII Q QO � CITY OF EVERETT LOCAL SALES TAX CODE IS 7103 <br /> WORK DESCRIPTION n �� � f s' <br /> / <br /> 5'VI.L/� ��Lc� G�'�YG V.f�RdG�(I�I � yo8 yp P' sF_ <br /> C�° o�(o y - ��(o -��v <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. . TYPE OF FI%TURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> p'Z BATHTUB 1_ FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) _ HEAT PUMP <br /> � SHOWER UNITHEATERS <br /> _� KITCHEN SINK&DISPOSAL ,_j__ CLOTHES DRYER <br /> � DISHWASHER �_ RANGE HOOD <br /> �_ LAUNDRY TR,4Y 1_ WATER HEATER <br /> _L CLOTHES WASHER METAL FIREPLACEISTOVE <br /> URINAL FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN � GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> _ BACKFLOW PREVENTER � GAS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <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 WWS 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 AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE LOCAL LAW TING C NSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWN THIS PR RTY T E M THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CO RA-TORS 18.27 RCW D .200 WAC. <br /> ature of 0 er o actor/Autho ed Agent ~� Dat �� <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED 3� � � � <br />