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P91MIT APPLICAT107 1 <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />UU..(41 C <br />SITE ADDRESS <br />- <br />PARPEL TAX I.D. k <br />PiTmrr N <br />2-"14-N Aye <br />2 0 <br />LEGA LOT NO. <br />DESC. 2 <br />BLOCK <br />TRACT <br />- <br />. <br />OWNER ADDRESS ZIP PHONE <br />LeyQc i��vvLeS ��fi Inc. I'm) S.��S+e�enSRd Zoo Uz-33` -0573 <br />lJt. Si-PoenzWA�.s'i< <br />TENANT NAME <br />CONTACT NAME PHONE <br />33q 7 <br />CONTRACTOR LE'L{NOVt22g/Jbt� ADDRESS VMG8•L ')jp0ensR .ZIP CONTR. LICENSE <br />�J wZ00 LFC 641voygEk- <br />PHONEyz-5-33`1-0573 �.Ste�ehs, VJA nZ6-y <br />PROPOSED USE OF BUILDING <br />PERMIT <br />Building f"1 Mechanical <br />Combin_Ilion ILK-J( Plumbin8 <br />Addition <br />WORK jR.� Alteration <br />MEAT SOURCE <br />Electric <br />S� <br />TYPE <br />Demolition Sign <br />TYPE g New <br />�J <br />Gas <br />Sprinkler <br />Repair/Main!. <br />Other <br />CONTRACT PRICE OF WORK , ' 1 �. <br />d U <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />-' <br />A/C-A/HANDLING UNITS <br />BATHTUB <br />-L <br />FORCED AIR SYSTEMS <br />3_ <br />LAVATORY (WASH BASIN) % % 1 <br />' <br />HEAT PUMP <br />- <br />SHOWER <br />- <br />UNIT HEATERS <br />KITCHEN SINK & DISPOSAL <br />�_ <br />CLOTHES DRYER <br />I <br />DISHWASHER <br />- <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />�_ <br />WATER HEATER <br />J_ <br />CLOTHES WASHER <br />- <br />METAL FIREPLACE/STOVE <br />- <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />_ <br />BACKFLOW PREVENTER <br />GAS PIPING <br />0/ <br />SINK (SERVICE/BAR/MOP/ETC.) <br />EXHAUST FAN <br />- <br />OTHER <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF t.AWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL RE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAY�TQRS 18../222/7/�ACW AND 2%.200 WAC. <br />,.lbn� <br />gnature of r on ractor/Authorized Agent Dal �L <br />r <br />r ���6 S <br />