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� � <br /> PERMiT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8657 <br /> SITE ADDRESS PARCEL TAX I.D.# RMI7# <br /> 5oi2 v3`� �►�e.NvE Wesr I DOb�b�ISDoOaLSOD �c��(�3-OI � <br /> DESC LOT N0. t S �D KDO TRACT <br /> �aaanaa� S�v;ewEss�s ���;�ro,� �-� <br /> OWNER ADDRESS ZIP PHONE <br /> �sc-N-n6�- Sorlas-ro� 5+�z Z3�A�e v� EJ�"I�JTT wA 942�3 C�kzs�3�8-o i 18 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �rU•tn.r �'ok11STDN �GLLCSa- � I�-�12 C� Dv�bT. �3laa�(c�o8-26�9 <br /> CONTRACTOR K_�u�, �cQ„�,ati ADDRESS �p�� K�,y,��µp��Q-., Z�P CONTR.LICENSEM <br /> (Zt1�w���4 RC�v.YZ�C . St�01'InN.�SI'� WA �L9�o �CRobbPP <br /> PHONE <br /> C'�loD)bfo8�Z-�a <br /> PROPOSED UnS�E OF BUILDING f� BUilding D MeChdnlCal Addilion HEAT SOURCE <br /> Si��G �twnl� PERMIT F.� Combinalion U Plumbing WORK R4-1 Alteralion R Electric <br /> TYpE �_..( Demolition U 5�9� T�'PE �( New Qg Gas <br /> res�i,(�enee u Sprinkler U RepalrlMalnt. U Other <br /> CONTRACT PRICE OF WORK BSpQ, � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION �M�J� ��,iSTil� �2ywA-l.l_ ilJ �hSR-�"«� IZ/�S?X1'(I N�� <br /> '�,..�sw\,a+�b,1 � rl�� aN� N e.u� �.r�.wct.2.Q ��-/7''�'�r(°�C � k le c�tri�.c�.l u�o�IL -�'o <br /> �'j,2 roX'�rOt M2�! l0� �'S • <br /> f <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM N0. TYPE OF FI%TURE�1R ITEM <br /> WATERCLOSET _ AIC—AIHANDLINGUNITS <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 FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICE/BARIMOPIETC.) _ EXHAUST FAN <br /> OTHER _ OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPF OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF.A PERMIT DOES NOT PRES:IP.:E TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAI LAW REGULATING CONSTRUCTIUIJ DF.THE PERFORMANCE OF CONSTRUCTION. THAT I AM AVTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM TfiE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.?00 WAC. <br /> C=_' 3 -9 ,�� <br /> �/.�.,c, i�mu.�— <br /> S�gn e o wn rlContrac r Authonzed Agent � Date <br /> DEBlT 8 CREDIT CARDS ARE NOT ACCEPTED <br />