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P�RMIT APPLICATIGnI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 42::-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMI7#/// � <br /> � /` ��, �� �/�u� ���5�. �A�x , �. e � <br /> cc� ��� � <br /> LEGAL LOT NO. 1.� LOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> �� �c,i�/!c �' � � n �u/u'wri�/, l��G %6�9 � <br /> � ��«�.�� /t,� � L C � Grr�� ��s� <br /> TENANT NAME � CONTACT FOR PERMIT PHONE <br /> �i� ���r �i °�7I' / I �� c f ', � �D / � Z�-3 - J <br /> CONTRACTOR ADDRESS / <br /> �� J / ZIP CONTR.LICENSE Il <br /> ���/C/� C(�� l y�G�l rcr��lo�: �� �Lc �O�' <br /> PHO E � ^ �L/4c�, /7 c� <br /> z`� `c3yq' SC%'yH ��Cw1���GrL 4J!� ( 1Y.,2?,5— /�I��C -LLIU/ (���/OJ� <br /> PROPOSED USE OF BUILDING Building Mechanical Addition HEAT SOURCE I <br /> / PERMIT Combination �Plumbing WORK �Alterafion ElecMc <br /> �,'1 � � —� TYPE � Demolition Sign TYPE New Gas <br /> �t�i �Ca- C'v i � C� Sprinkler Repair/Maint. � � Other <br /> CONTRACT PRICE OF WORK - � n ICI T7 OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � 5� < C. <br /> WORK DESCRIPTION <br /> �h�T,�E���� �a1 �ti.�-��4� (� r//cc �, , ���( G�'rL(( 5ic G� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. 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 UNITHEATERS <br /> _ KITCHEN SINK 8 D�SPOSAL CLOTHES DRYER <br /> _ DISHWASHER RANGE HOOD <br /> _ LAUNDRYTRAY 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 jSERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> _ OTHER OTHER <br /> I HEREBY CERITIFY'i NAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNUW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING TF11S T'/PE OF INORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUh1E 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 /> CONTRACTORStAW 1827 RC4y AND 296.200 WHC. <br /> / / <br /> !1': ��:��f-,=��-T�--- i �'��/l✓ <br /> Signature of OwneriConiractod.4uthorized Agenl i Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> Z <br />