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�tRMIT APPLICAT�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-9857 <br />S�TE ADDRESS 9�37 ,�� Q✓� SE pqpCEL TAX I.D. # • <br />LEGA LOT N0. BLOCK TRACT <br />DESC. � <br />OWNER ADDRESS <br />LP <br />8�v� .�, ��� c�,�s% Po �9ox 3 z avvq-�c , 9�ni 9 <br />TENANT NAPdE I CONTACT NAME <br />CONTRACTOR �Q��SpN �yu � ADDRESS <br />� 3 �v /1�iTK .QvCr .c.t <br />PHONE �(Od)�03-7i�ia3- +�fLL�.�.C��YJi.. <br />PROPOSED USE OF BUILDING <br />Building Mechanical <br />PERMIT �Combination R Plumbing <br />TYPE Demolilion � Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK � }��� <br />W V HR UtS(:RIPTION <br />/NSTi4tc F�,P� SO,er,cr���7Q <br />PLUMBING <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHE" ^�NK 8 DISPOSAL <br />DISHW, ;rR <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOF DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE'BAR/MOP/ETC.) <br />OTHER <br />TVPE <br />PERMIT M <br />IL �(o -G� <br />�2a�� 8i9 - ���� <br />PHONE <br />ZIP CONTR. LICENSE N <br />`1�zy3 2oBiNAkz�zcZ <br />Addition I HEATSOURCE <br />Alleratlon Electric <br />New � Gas <br />Repalr/Maint. U Other <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />S�srz� iti. ��k- S r-,e <br />N0. � TYPE OF FlXTURE OR REM <br />_ A!G - A/HANDLING UNITS <br />_ FORCED AIR SYSTEMS <br />HEAT PUMP <br />_ UNIT HEATERS <br />_ CLOTHES DRYER <br />_ RANGEHOOD <br />_ WATER HEATER <br />_ METAL FIREPLACE/STOVE <br />_ FIREPL4CE INSERT <br />_ GAS FIREPLACE <br />_ GAS RANGE <br />_ GAS PIPING <br />_ EXHAUST FAN <br />_ OTHER <br />L� .SOP�,�.«c�s-,.yDs <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ANU KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF fAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUM� TO GIVE AUTHOFIN 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 PqOPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOFS LQW 1Q.2�.JaCW ANDZ,Q6200 WAC. <br />