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P�RMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 2308 2(��''" ST 9 i )C pC�d� 'O/a <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> LA�2y $ Low-,�1 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> � iv�f� S.kw-„ S�o,�,.� �rzr--z�z- � co�c <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> PHONE �'',A ` � / <br /> I�t�'v' `--� <br /> PROPOSED USE OF BUILDING � Build'I�g � Mechanical Addition HEAT SOURCE <br /> PERMIT Combination Plumbing WORK R Alte2tion � E�ectric <br /> n - TYPE Demolition Sign TYPE 1_� New Gas <br /> /�AD`-�vr�n... Sprinkler qu Repair/Maint. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> � .4.vt �L�7�L�9c �N[r .K.- ��� Pc.,ir�h�•.ic.— <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> 1 BATHTUB FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNITHEATERS <br /> / KITCHEN SINKl� DISPOSAL CLOTHES DRYER <br /> % DISHWASHER RANGE HOOD <br /> % LAUNDRY TR,4Y Z 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/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> i <br /> � I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> I PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITM WHETHER SPECIFIED HEREIN OR <br />� NOT. THE G TING OF A P MIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISI�N OF ANY OTHER <br /> STATE OR L LAW REG LATI CONSTRUC OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF IS PROPER TO P�R ORM TH O FOR WHICH APPLICATION IS MADE AND I COMPLY WIT4 THE STATE <br /> CONTR ORS LAW 18.27 CW AN 296.200 . <br /> - — G 30 ?ou <br /> Signatu Owner/Contracto orized Agen at �� <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />