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. + 1(�t- ,'tl,D�nL6 Ci <br /> PERMIT APPLIC/n►TION �,�.�4-c 40 <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 I <br /> 425-257-8810-FAX 425-257-8857 <br /> P RMIT� <br /> SITE ADDRESS f PARCEL TAX I.D : /� /j� -� <br /> I�i,.i�.J`� IL}lU 1. . �_'�' 1? L�i �_ / G' � �L�'�� <br /> .. � n:�-,. ` �.� I <br /> LEGAL LOT NO. BLOCK T��' <br /> DESC qp pHp�� <br /> ADDRESS <br /> OWNER <br /> i:�l'.1G�1'1i�h1 I7iJ��Xi.L;.t�'1i;r.ii �:L �''_C;,: ICiJi G->i-tt{-yJ-�ll�+ YVl'. `[b�`(� %� SC(t3 <br /> CONTACTFORPERMIT PHONE <br /> TENANT NAME ` I�'J,l'i7Clt�. �LbCL2-- ���?TTtIiI��'�'Yr��� 'L�� -���7 f-'Cl� <br /> �«�I� � L� 1 ��`lY-� LP CONTR.UCENSEi <br /> ADDRESS <br /> °���°� �c�' .P.o.�?-a�-. =��� �.�u�y�u�l `1�2;z?� ���-r4v�•I��l�', <br /> PHONE <br /> Q2`o -Z��J "lL`t(�� <br /> Building Mechanical Addition I F;EAI'SOURCE <br />� PROPOSED USE OF BUILUING Q n Eleclric <br /> t���� ����GN PERMIT Combination U Plum6ing WORK NleraGon � Gas <br /> I TYpE � Demolition U Sig� TYPE N� <br /> � � Sprinkler RepairlMaint. Other <br /> CO'NTRACT PRICE OF WORK �' . C%EU CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> ZC-'• <br /> WORK DESCRIPTION <br /> "1i:1L�t�''; Ir�r:GGi.�'{x"lt=t-l�' <br /> - PLUMBING MECHANICAL <br /> N0. 7YPE OF FI%TURE OR ITEM <br /> NO. NP�.OF FIXTURE OR REM <br /> WATER CLOSET AIC—AIHANDLING UNITS <br /> � BATHTUB �_ FORCED AIR SYSTEMS <br /> � tAVATORY(WASH BASIN) � HEAT PUMP <br /> SHOWER � UNIT HEATERS <br /> KITChiEN SINK&DISPOSAL ^ �CLOTHES DRYER <br /> � DISHWASHER RANGE HOOD <br /> LAUNDRY TR,AY_ ✓ W/1'CER HEATER <br /> = CLOTHES WASHER, _ METAd�FIREPLACFJSTOVE <br /> URINAL �� _. FIREPUiGE1N5ERT <br /> DRINKING FOUNTAIN ` _, GAS FIREPLACE <br /> FLOOR DRAIN �� _ GAS RANGE <br /> BACKFLOW PREVENTER � _ GA3 F�P�NG <br /> •i SINK(SERVICE/BAR/MOP/EfC.) �\ _ EXHAUST FAN <br /> OTHER ,_ OTHER <br /> _' — �. <br /> I HEREBY CERITIFY THAT I HAVE FiEAD AND EXAMINED THIS APPL�GATION AND KNOW THE SAME TO BE IRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEC WITH WHEfiiER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY OTHER <br /> STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE PEFiFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY hIE <br /> OWNER OF THIS RROBERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORB lAW 827 RCW AND 296.200 WAC. ,-� �� <br /> � _.. �� ,; ,,� � � �r;. .� � ,� � � l, <br /> Signatu2 of OvmedContractor/Authonzed Agent Date '/�) <br /> f <br /> DEBIT 8 CREDIT CARDS ARE IdOT ACCEPTED <br />