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�EI�MIT APPLi��►TION Z` I <br /> CITY 4F EVERE�'T PERMIT SERVICES <br /> 32U0 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDR'eSS PARCEL TAX I.D.� PERh11T# <br /> (8 / � �,� v'e u.� �✓' I CO�lC;3- D� (o <br /> LEGAL I.OTNO. BLOCK TRACT � 9 <br /> DESC. u (y�{1�`� i,(/AODS <br /> OWNER ADDRESS LIP PHONE <br /> L�---r i�e,�ui�� dr[s , /�C. �o f1a�Y /s 79 S��f,4,,n�1;�ui�9 Y�YzJ`l ;%tJ" 3s J-/dao <br /> TENANT NAME I CONTACT FOR PE MIT � PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> C(/Vl_.�-- <br /> PHONE � <br /> �/LS 3S"rl- /v�o l'v BoR /S�cl : .frJa!/�r��.(� u��Q- r-/ 6'zy'/ 2'H-tS�t'N jF�u�s'�3 <br /> PROPOSED USE OF BUILDING Building f'� Mechanical Addition HEAT SOURCE <br /> �� � �� PERMIT Combination IF-�-( Plumbing WORK R�( Alteration Electnc �� <br /> TYPE Demolition LJ Sign TYpE �.�J New � Gas <br /> Eprinklsr U RepaidMalnl. Other <br /> CONTRACT PRICE OF WORK y' /S��J I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 — I <br /> (D <br /> WORK DESCRIP?ION <br /> n��s �2 �i� 22�� i35� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM . NO. TYPE OF FIXTURF OR ITEM <br /> 3_ WATER CLOSET(TOILET) — A/C—A/HFlNDLING UNITS <br /> � BATHTUBIJ�� / FORCEDAIRSYSTEMS <br /> � LAVATORY(WASH BASIN) � HEAT PUMP <br /> — SHOWER UNITHEATERS <br /> �_ KITCHEN SINK& DISPOSAL �_ CLOTHES DRYER <br /> � �ISHWASHER � RANGE HOOD <br /> IAUNDRYTRAY _(_ WATERHEATER <br /> � CLOTHES WASHEF. ^ METAL FIREPLACE/STOVE I <br /> — URINAL � FIREPLACE INSERT <br /> = DRI�JKING FOUNTAIN � GAS FIP,EPLACE <br /> � FLOOR DRAIN GAS RANGE <br /> = BACKFLOW PREVEN i ER � GAS PIPING <br /> ^_ SINK(5ERVICE/BAR/MOP/ETC.) � EXHNUST FAN <br /> OTHER OTHER <br /> _ I — <br /> ' I <br /> I HERE9Y CERITIFY ThIAT I HAVE RE.vD A�D EXAMItJED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL. <br /> I PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPEGFIED HEREIN OR <br /> NOT. THE GRANTING OF P.PERMIT DOES NOT PRESIiME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE FROVISION OF ANY OTHER � <br /> STATE OR LOCAL lAW f; GULATING CONS`�RUCTION OR THE PERFORMANCE OF CONSTRUCTION. TH4T I AhS AUTHORIZED P,Y THE <br /> OWNER OF THIS PROP TY TO PERFORM THE WORK FOP.WHICH APPLICATION IS PdAUE AND I COMPLY WITH THE STATE � <br /> COIJTRA ORS LAW 1 7 RCW AIJD 296.200 WAC. I <br /> G; � /J O I <br /> Signatu e of Ow enContrector u orizetl Agent Date �/Z <br /> � <br /> DEBIT 8 CREDIT CARDS ARE NQ7 ACCEPTED i <br />