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p�RMIT APPLICATIC``.�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-25�-8810- FAX 425-257-8857 <br /> pK�, � �/- o S3 <br /> SITE ADDRESS PARCEL TAX I.D.# / PERMI7# <br /> (�' � �J " � -� DD� �oD/O /6�� � D `D3� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP pHONE <br /> �/,�,e%//C�C' Sl�c/�B.E'z .�(J(/�s'T 11C' <br /> TENANTNAME CON7ACTFORPERMIT PHONE <br /> �UC�y T�C�/�"l� � �� <br /> CONTRACTOR ADDRESS � ZIP CONTR.LICENSE# <br /> aHo E/��Sn.J.3L �-�lS�r�C'�•cfcK� �-/�o �(/LJ �✓i�i1oL�-4 L �, _ 'k <br /> �/ �� d/S`�'6 <br /> _ -k�6� 9�r9— 3 o S�s� N;//�/1��a o�' %��23 <br /> PROPOSED USE OF BUILUING �EQ Building ISa Mechanical Addition I HEAT SOURCE <br /> PERMIT �� � Combination K Plumbing WORK � Alteration �Electric <br /> 1YPE �l Demolition U Sign TYPE New Gas <br /> U Sprinkler Repair/Mainl. I Olher <br /> CONTRACT PRICE OF WORK � '<<`= CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> i./1 [f9n <br /> WORK�ESCRIPTION <br /> �"z � i�o�� � /o���C <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 /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> _ DISHWASHER _L RANGE HOOD <br /> LAUNDRY TRAY 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 REAU AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETFiF.R 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 /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> " - � �� .�i��'^ /�-�-�/d !t <br /> nature of Owner� onhacrodAuthorize gent — Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />