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SUL-27-2D06 07:11 FROh1:PERMIT 4257756315 T0:14252578857 P.2 <br /> 1 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICE� <br /> 3200 CEDAR STREET, EVERETT, WA 3820't <br /> 475-257-8810— FAX 425-257-8857 <br /> SITE AIJDRESS PARC[L TAX I.D.# P,FR�AI�z � � <br /> oCPI ld�` ,(�r-s � Oc� 97oo�o�yoo -�;��,,��>� -�Z <br /> LEGA LOTNO. CLO^.K TRACT <br /> DESC. <br /> OWNER AOORESS ZIP PfiONE <br /> Vcr�,lro �.r-�- �c/� ld��� �d�,9,-f� ��1� 4�zrs�3� issz <br /> TENAN NAME CONTACTFORPERMIT PHONE <br /> <(��l�-�' � /C-�/Id�.. �zS 2�r-- 8 '�t5� <br /> CO��TOR� �,,,,^ �,_,_� (�n �,�� ADDRESS ZIP CONTR.LICENSE# <br /> ur-r Z/�(X7� Cj+cq V/ vCr�if/�l/�'f�7/ <br /> PHO�� �L y7cv �"� ����� � �g,�i 9 Y � <br /> G <br /> PROPOSED USE OF BUIL�ING Blllidl�g �Mechanlcal uunn Addlll0n MEAT SOURCE <br /> PERMIT � Combination Plumbin9 WORK � Alteralton �lectric <br /> � � TYPE Demolilion Slgn TYPE New Gas <br /> Sprinkler Repalr/P.4aint. ther <br /> CONTRACT�RICE OF WORK �/' �—[� �. CITY OF EVERETT LOCAI.SALES TAX C0�615 3105 <br /> CO � 7 � <br /> WORK DESCRIPTION <br /> ��..rfi�l����� �,,.�pl�� ����' �- �4� ���� �� <br /> � d r..������ ��f ��� �e�.�' <br /> PLUMB�VG MECHANICAL <br />� NO. TfPE OF FIXTUR[OR ITEM NO. TYPE OF FIXTURC-OR IT[M <br /> WATER CLOSET(�OILET) __ A/C—A,'HANDLING UNITS <br /> BATHTUB FORCGD AIR SYSTEMS <br /> LAVATORY (WASIi BASIN) HEAT PUMF <br /> SHOWER UMIT HEATERS <br /> KITCfiEN SINK 8 DISPOSAL CLOTHES DP,YER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY � WATER HEATER <br /> CLOTHES WASHER METAL FIREPfACE/STOVE <br /> _ URINAL � FIREPLACE INSERT , <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DW1�N GAS RANGE I <br /> BACKFLOW PREVENTER �_ GAS PIPING I <br /> SINK (SERVICE/RAR/MOP/FTC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND E.XP.�ViINED THIS APPLICATION AN�KNOW THE SAME 70 BE TRUE FNG C�iRRECT. ALI. <br /> PROVISIONS OF LAWS AND ORIDINACES COVER�ING THIB TYPE OF t^lORK VJILL BE COMPLIED WI7H WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTII�G OF A PcRM111T DOES NOT FFcSUA1E i0 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANl'OTHER <br /> 51 A�E OR LOCAI LAIN REGULA7ING CONS I RUC110N OR THE PEHFORI.1ANCE OF CONSTRUGTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE'rvORK rOR N'HICH APPUCP.TION IS MADE AND I COtAPLY WITH THE STATE <br /> CONTR CTORS LA � .?7 RCW AND 29'0."<0 <br /> G1t�(�. " 7U1 ! C_J ��Z�O � <br /> Si at re of OwnedContractor/A rized Agent Dale �i <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> J <br />