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, <br /> P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C:EDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS/�!/9 I9 A�E S� PARCEL TAX I.�.# PE}2MIT# <br /> � �L �{Oa -OD3 <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> Te ; a C � - �3 <br /> CONTRACTOR��/� �1��}� ADDRESS ZIP CONTR.LICENSE# <br /> PHONE , ,,' ', � � �J�' ,5�$3�. ��1.�/l���t. ���� <br /> _ C� .3s.�- 9�13 ,t��s���t y�s <br /> PROPOSED USE OF BUILDING pERMIT �—( Spfinki'ealion � Plumbingal W�RK �(,Repair/Maint, HEAT SE eRnE <br /> TYPE H Demolition Sign IYPE p� New Gas <br /> Ll "L3 ONer <br /> CONTRACT PRICE OF WORK J�pf,� CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> /7C:(i{ <br /> WORK DESCRIPTION <br /> /�l�I��P ���Gr 1�J"e ,S�j�/�-�'�D�l S�/.�7�"�'l'I <br /> PLUMBING MECHANICAL <br /> NO. I 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 /> SHOW ER UNIT HEATERS <br /> KITCHEN S�NK 8 DISPOSAL CLOTHES DRYER <br /> DISHViASHER RANGE HOOD <br /> LAUNDRY TRAY WATER FiEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPI.R�CE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN � GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOPIETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ ANII EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GC`VERNING THIS TYPE OF WORK WILL 8E COMPLIED WITH WhIETHER SPECIFiED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NGT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL 7HE P40VISION OF ANY OTHER <br /> STATE OR LOCAL W REGULATING CONSTR JCTION OR THE PERFORMANCE OF CONSTRUCTION. THAI'I AP,I AUTHORIZED BY THE <br /> OWNER OF THI P PERTY TO PERFORM TH�=WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WiiH THE STATE <br /> CONTRACT�iiS W 1 2'RCW AND 296200 I <br /> � �� �� —� <br /> Signat of nedContracto uthonzed A nt Date � <br /> ��L <br /> DEBIT & CR 1T CARDS ARE NOT ACCEPTED <br />