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, ��RMIT APPLICATI�N � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9t32G1, 425-257-8810 <br /> SITE ADDRESS �'r1�RE'j�T� �I¢• PARCEL TA%I.D.p PERMIT k <br /> /'80y a�f�',�R , 5'C. 0�927�-oao-o //-o�o '4?D' -- I <br /> LEGAL LOTNn BLOCK TRACT <br /> DESC. rI -- <br /> OWNER i ADDRESS � PHONE <br /> � (4251 626-8373 <br /> Quadra�it ComoraLion j P.O. Box 130; Bcl.lewe, iVA 98009 I (425x 455-2900 <br /> TENANTNAME CONTACTNAME PHONE <br /> I F:atrina Toole I (425) 6AG-8373 <br /> CONTRACTOR � ADDRESS � CONTR. LICENSE# <br /> � <br /> "Sa�ne as Owner" i QUADRC*221.Of <br /> PHONC � <br /> 425 455- <br /> PROPOSED USE OF BUILDING Building Mechanical Addi�ion HEA SOURCE <br /> PERMIT ?1R�Combinalion R�( Plumbing WORK Alteration lectric <br /> Single Pa�ni.ly Residetice TYPE �] Demolition U Sign TYPE �New Gas <br /> U Sprinkler U RepairlMaiat. O�her <br /> CONTRACT PflICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 — <br /> WORK DESCRIPTION <br /> Singlc Pa�niZy Residence W�DETdCIt!'� �}1�I��f <br /> uadrai D ' Lt v E G O��/�9 <br /> PLUMBING M HANICAL <br /> Np, TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTUqE OR ITEM <br /> � WATER CLOSET _ A/C—A/HANDLING UNITS <br /> � BATHTUE FORCED AIR SYSTEMS <br /> IAVATORY(WASH BASIN) �/ HEAT PUMP <br /> SHOWER /� UNIT HEATERS <br /> / KITCHEN SINK& DISPOSAL � CLOTHES DRYER <br /> � DISHWASHER , I R,4NGE HOOD <br /> LAUNDRY TRAY � WATER HEATER <br /> � CLOTHES WASHER _ MEfAL FIREPLACElSTOVE <br /> URINAL ,_ FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DNAIN � GAS RANGE <br /> BACKFLOW PRE�/ENTER EXHAUST AN <br /> SINK(SERVICE/F3AR/MOP/ETC.) OTHER <br /> � OTHER��gr��y��— — <br /> — pj1 _ — <br /> I HEREBY CERITIFY TfiAT I fiAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIOINACES GOVEfiNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN Ofi <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIIY TO VIOIATE OR CANCEL THE PHOVISION OF ANY OTHER I <br /> STATE OR LOCAL U1W REGUTATING CONSTRUCTION OR THE PEAFORPAANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TNE <br /> OWNER OF THIS PROPERIY TO PEPFORM THE WORK FOR WHICH APPLICATION IS MAOE ANO I COMPLY WITH THE STATE <br /> CONTRACTOfiS lAW 1827 RCW AND 296.200 WAC. <br /> �� � .;.� _ on behalf of uadaant � � �k <br /> ign lur o( wnedContractodAulharized Agent D e <br />� . — <br />