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�ERMIT APPLICA�"flN <br /> CI OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982p1 <br /> 425-257-8810-FAX 425-257-8857 ' <br /> S�9��5 zS� P�? ��a - o,� <br /> PARCEL TAX I.D.A PE �T� <br /> � �SE �9yo7-o�-e3s-oo I �.302��'3 <br /> LEa:� LOZNcO�. BLOCK — <br /> DESC. J!J TR�T/l� � <br /> /<<Lfi <br /> OWNEp IBK� aOELK,���GvJ,��/ � aP PHONE <br /> �s/f�is .f./!�!!,T�/G c�CsrEc�rs �,v� 5�s3 y1r-33�/�s73 <br /> TENANT NAME I CONT C►'NAME <br /> PHONE <br /> -��.�/ �>�C��_ Hzs=3.�%as-�3 . <br /> CONTRACTOR qDDqESS <br /> ZIP CONTR.UCENSE I <br /> PHONE / <br /> — �� .�,/ls:- .�.d� LE6i1c'�H.c6�/�i'�P.K <br /> PROPC: EOFBUILOING BUilding r� MBChaniCal <br /> PERMIT �j Combination r� Addition HEAT SOURCE <br /> H Plumbing WORK Alteralion Electric <br /> ���� IYPE D Demolition Ll Si9� TYPE New <br /> U Sprinkler Ges <br /> Fepair/Maint. Other <br /> CONTRACT PqICE OF WORK <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> WORK DESCRIPTION <br /> b/I� � . <br /> %/�'�G �zZZ� <br /> PLUMBING <br /> N0. TVPE OF FIXTURE OR REM MECHANICAL <br /> NO. TYPE OF FlXTURE OR ITEM <br /> WAT�R CLOSET <br /> BATH7U8 —" A/C—A/HANDLING IiNITS <br /> LAVATORY(WASH BASIN) —L FORCED AIR SYSTEMS <br />, � SHOWER = HEAT PUMP <br /> _L KITCHEN SINK 8 DISPOSAL " UNIT HEATERS <br /> � DISHWASHER _L CLOTHES DRYER <br /> LAUNDRY TRAY � RANCE H000 <br /> Z CIOTHES WASHER . � WAT� A HEATER <br /> URINAL = METAL FIREPLACE/STOVE <br /> DRINKING FOUNTAIN — FIREPLACE INSERT <br /> FLOOR DRAIN —L GAS FIREPLqCE <br /> BACKFLOW PFEVENTER GAS RANGE <br /> I SINK(SERVICE/BAR/MOP/ETC.) GAS PIPING <br /> OTHER EXHAUSTFAN <br /> _ OTHER <br /> �_ <br />' —�� _ �_— <br /> I —�-- <br /> I HEREBY CERITIFY THAT I HAVE FEAD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANG COflRECT. ALL <br /> PROVISIONS OF tAWS AND ORIDINACES GOVEqNING THIS TYPE OF WpRK WILL BE COMPLIED WITF{WHEfHER SPECIFIED HEREIN Qfi <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE PFOVISION OF ANY OTHER � <br /> STATE OR LOC �(_qyy REGULATING CONS:RUCTION OR THE PERFORMANCE OF CONSTRUCTION. TFWT I AM AUTHORIZED BY THE <br /> OWNER 7 . S PROPERiY TO PEqFORM THE WOFK FOR WHICH APPUCATION IS MADE AND I COAIPLY WITH THE STA7E <br /> CONT F�'4IV 18.2 ANC��O WAC. �/�� <br /> Signal re ol OwnedContractouAuthorized Agen! <br /> ale ��l/ <br />