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,•,.:..�,_�.�_ . <br /> P���wAAIT �#PPLICATIO� <br /> CITY OF �VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA`Q8201 <br /> 4 , 257-8810- FAX 425-257-8857 � C � <br /> � ' G _"1�-O <br /> SITE AD�RESS t� PAR�EL TAX I.D.! P�RMR M i <br /> � S-2� �l�e.SE 2805� 700 o c� c� bS- 3 � <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. Gr'G � ��— 'O <br /> OWNER ADDRESS LP PHONE <br /> Le�ac.�.{ I�Ovne5PIW1nC. �SIbS.����e��• #�° c�Z$'33y�573 <br /> LFiS�e �Pv�s� S�_ <br /> � TENANT NAME CONTACT NAME PHONE <br /> j I �rinC�;�ber+5or� �1 Z6 <br /> i /kel/iVl �+OC�G�e 33Y•0.573 . <br /> � CONTRACTOfl ' • � ;•� ,pODRESS � . - ZIP CONTR.UCENSE• <br /> L c,c l�omPStJ�nJlnC• �g►l�S.��c.S�.vensRd•#za� <br /> � �I . p� LEC--�q�NNOVU2K <br /> PHONE - � S�f.�2YlSi W� '� a �� •• ' • <br /> � PROPOSED USE OF BUILDING Building Mechanical - Addition NEAT SOURCE <br /> PERMIT �Combination R Plumbing WORK �A1leralion �Electric <br /> ; �('2 7YPE D Demolition � Sign TYPE New Ges <br /> I <br /> �� U Sprinkler Repair/Maint. Othar <br /> I�� CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> `YORK DESCRIPTION <br /> I �^ <br /> i Plar,� zocoo �B=�.S'�c� 22 2 I <br /> PLUMBING MECHANICAL <br /> � NO. TYPE OF FIXTURE OR REM NO. TYPE OF flXTURE OR REM <br /> i � WATER CLOSET A/C—A/HANDLING UNITS <br /> � BATHTUB � FORCED AIR SYSTEMS <br /> I � LAVATOFY(WASH BASIN) _ HEAT PUMP <br /> , SHOWER UNIT HEATERS <br /> �- KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> / D�SHWASHER _ RANGE HOOD <br /> � _ LAUNDRY TRAY _L WATER HEATER <br /> I � CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> _ URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN �T GAS FIREPLACE <br /> _ FLOOR DRAIN / / GAS RANGE <br /> _ BACKFLOW PREVENTER `T GAS PIPING <br /> _ SINK (SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> _ OTHER _ OTHER <br /> I HEREBY CEFITIFY THAT I HAVE REAO AND EXAMINED THIS APPLICATION AND KNOW TFIE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISION.i OF lJ1WS AND OFIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> NOT. THE GHANTING OF A PERMfi DOES NOT PRESUht�TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHEFi <br /> STATE OR IOCAI LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE VJOFK FOR WHICH APPLICATION IS MADE AN01 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �m1�:�a��<.� '�s�-�: sl� �4� <br /> S ature o Ow� edContrectorlAutlionzed Agent 'Date <br /> ��Z <br />