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' � P�RMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> SITE ADDRESS ��jQ�u�A- PARCEL TAX I.O.w PERMIT N <br /> / �� o?�� �/�ivE sr. mo9a�y-oo�-o� - oo _ � � <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER � ADDRESS PHONE <br /> Quadrant Corporation � P.O. Box 130; Bellewe, IVA 98009 � �425j 455 2900 <br /> TENANT NAME i CONTACT NAME I PHONE <br /> Katrina Toole ! (425) 646-8373 <br /> i <br /> CONTRACTOR i ADDHESS � CONTR. LICENSE k <br /> PHONE�e as Owrter" � � QUADRC�'2210P <br /> 425 - i <br /> PROPOSED USE OF BUILOING Building Mechanical Addition HEAT SOURCE <br /> PERMIT Combinalion Plumbing WORK PJteration Electric <br /> Single Pamily Residence TypE � Demolition Sign TYPE �New � Gas <br /> Sp�nkler RepaidMaint. Other <br /> CONTRACT PflICE OF WORK CITY OP EVEREff LOCAL SALES TAl(CODE IS 3105 <br /> WORK DESCRIPTION <br /> Single Family Residence w/pE��r`Fc"7� G14�2f}(-t <br /> uadr - 028 9 ' G T ��' �"�'�i Ei T P C O S!C- � ai67 ��7 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF flXTUpE OR ITEM NO. TYPE OF FlXTURE OR ITEM <br /> �, WATER CLOSEf _ A/C-A/HANDLING UNITS <br /> _� BATHTUB _ FORCED AIR SYSTEMS <br /> _� LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER 5 UNITHEATERS <br /> _L KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> � DISHWASHER � RANGE H000 <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 PREVENIER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> OTHER�g g�� _ OTHER <br /> 1 HEFiEBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION ANO KNOW THE SAME TO BE TRUE AND CORflECT. ALL <br /> PflOViS10N5 OF LAWS AND ORIDINACES GOVCRNING THIS TYPE OF WORK WILL 0E COMPLIED WITH VYHETHER SPECIFIED HEREIN OR <br />� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHOFI7Y TO VIOLATE OR CANCEL THE PROVISION OF ANY OTNER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOPMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNEH OF T."IS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE!WD I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �S�i»��.,.!>, on behalf of Quadaant ����vz � <br /> Signa� re Owner ContradodAuthonzed Agent Date Z <br />