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P�.RMIT APPLICATIQr.V <br /> CITY OF EVEREIT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.N PERMIT N <br /> l�j� ( — �- 7� �L s, /11d2/G-G3 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS <br /> ZIP PXONE <br /> 4--+�� <br /> TENANTNAME . I CONTACTNAME PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR.LICrN3E M <br /> PHONE <br /> PROPOSED USE GF BUILDING Building I"1 Mechanical f'l Additlon HEAT SOURCE <br /> PERMIT R COmbineli0n H Plumbing WOqK K Alleretion Eiectrk <br /> TYPE D Demolition U Sfgn 7YPE �.� New � Qas <br /> D Sprinkler U RepeiNMeint. Other <br /> CONTRACT PRICE OF WORK CIT/OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> INO. TYPE OF FU(TURE OR REM N0. TYPE OF flXTURE Oq REM <br /> I _ WATER CLOSET _ A/C—A/HANDLING UNITS <br /> ? _ BATHTUB _ FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) ,_ HEAT PUMP <br /> � _ SHOWER _, UNIT HEATERS <br /> i _ KITCHEN SINK & DISPOSAL _ CLOTHES DRYER <br /> � __ DISHWASHER _ RANGE HOOD <br /> � ,_ LAUNDRY 1'RAY _ WATER HEATER <br /> ' _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> _ URINAL _ FIREPLACE INSERT <br /> I _ DRINKING FOUNTAIN _ GAS FIREPLACE <br /> _ FLOOR DRAIN _ GAS RANGE <br /> _ BACKFLOW PREVENTER _ GAS PIPING <br /> _ SINK(SERVICE/BAR/MCP/ETC.) _ EXHAUST FAN <br /> _ OTHER _ OTHER <br /> i — <br /> — U4'�L'7 lt r <br /> I NEPEBY CERITIFY THAT I HAVE READ AND E:tAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOb'ERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOUITE OR CANCEL THE PROVISION OF ANY OTHER <br /> S TE OR LOC LAW REGULATING CONSTRUCTION OR Ti.E PEFFORMANCE OF CONSTqUCTION. THAT I AM AUTHOR2ED 9Y THE <br /> W ER OF THI ROPER TO PERFORh!THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CO RACTOFS 18.2 CW AND 296200 WAC. <br /> na r of n /Contract dAuthonzed Agent e � <br />