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I ��'�MIT APPLICATIC'' f � <br /> � CITY OF EVERETT PERMIT SERVICES � ��Z_p6 <br /> '� 3200 CFDAR STREET, EVERETT, WA 98201 ��.\ <br /> � 425-257-8810- FAX 425-257-8857 <br /> ' ��/Z C�,�� <br /> SITE ADDRESS � PARGEL TAX I.D. # ERht1T a <br /> �,1, � , - ��� ��v� �� �= :,���� �l.LG� :.L' I��C' �1(.��:� C, -G5 <br /> LEGA LOT N0. 9LOCK THACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE � <br /> �l 1�� ..sfi*.,n�5 L.L C. �0 Ci'i.5 j���� l ve S� �E7-t:t;� '�-1.5-? i 7 -6 rd y <br /> TENAIJT NAME CONTACT NAME PHONE <br /> q � <br /> 1uJ:u� 1'Ir+�4wl G;,.c 'vtl�4^,� ,�,�3'-�',�r �- �Sut <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE N <br /> i �-��,., ',..,.;Sve- LG T iy,. (1 <br /> ,�-:l�r�� t�.�:_ ��,�-ioc�,.,i; ��t�, . � Ifv�q».<<. �h qU . :�- f/�������O�i�(:�� <br /> PHONE <br /> -.5.1 'i? b • �),`iC <br /> PROPOSED USE OF BUILDING Building f"1 Mechanical Addition HEAT SOUFCE <br /> ' PERMIT � CombiQation H Plumbiny WORK �Alteralion � Electric <br /> TYPE Demolilion LJ Sign TYPE New Gas . <br /> �/!„ ^ �� Sprinkl�_f Repair/Maint. Other ' <br /> ,1,-.. U i-�;. e. <br /> CONTRACT PRICE OF WORK � _�/ ��_�i J qTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> <<� /_Ic'��C�'' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CIOTHES DRYER <br /> DISHWASHEFI RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES`NASHER METAL FIREPLACE/STOVE <br /> URINAI FIREPLACEINSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.j EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXA�dINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL <br /> PROVISIONS OF LAWS AN�OflI01NACES GOVERNING THIS 1YPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIIY TO VIOLATE OR CANCEL THE Pi70VISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOR�dANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 6Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR bVHICH APPLICATION IS tdAOE AND I COMPLY WITH THE STATE <br /> 'RACTOHS LAW 1827 qCW AND 29fi200 WAC. <br /> (�i� `i•,i��� � 11- ��;—c6 <br /> Signalure ol OwnedContractor/Aulhorized Agent Date �� <br />