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P�RMIT APPLICATIO� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9�'201 <br /> 425-257-8810 - FAX 425-25/-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMlIT/# <br /> � '`' ^, e. - o I oo5 �97voioi bc7 � I � Y�3 - �/D <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> o�jaad�0 s,�p„�� + P.D . io59 ne�,o�,' �i I��� 9'A.�9 / <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> I (h �k� N ,�aor 36o - 65i - �7o� <br /> CONTRACTOR AODRESS ZIP CONTR.LICENSE# <br /> Sm�+i. F�Ra S�S�en. S 3813 16 `bT `� S'{ . IV. E, �I <br /> PHONE <br /> 36o - hsi - �� o� ►�21 � n� -4, W �l 98aa3 St�z7H/Fsi36oT <br /> PROPOSED USE OF BUILDING Buildin� D�Mechanical Addition HEAT SOURCE <br /> PERMIT � Combination U Plumbing WORK � Alteration � Electric <br />� (� TYPE Demoliti0n U Sign TYPE ��ew Gas <br /> Dp{ilpe� 51.�o Spfinklef Repair/Maint. p�e� <br /> CONTRACT PRICE OF WORK i CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> �IOoo <br /> WORK DESCRIPTION <br /> Add Io �cAda �o Irna�-4 �mPRov�r» n� <br /> PLUMBING MECHANICA�_ <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> _ WATER CLOSET(TOILET) A!C—AlHANDLING UNITS <br /> _ BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNITHEATERS <br /> _ KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> _ DISHWASHER R,4NGE 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.) EXHAJST FAN <br /> _ OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ 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 COA1PLIED WITH WHETHER 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 LAbV REGULATING CONSTRUCTION OR THE PERFORA4ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I CUMPLY WITH THE STATE <br /> ONTRACTORS LAW 8.27 RCW AND 296.20D WAC. <br /> ��_ /1 '� .,�._ 3 -.? 6 -o Y <br /> Signature of Ow dContractodAuthonzed Agent Date <br /> DEBIT 8� CREDIT CARDS ARE NOT ACCEPTED <br />