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���MIT APPLICAT'Ie.,N <br /> CITY OF EVE:RETT PERNlIT S�RVICES <br /> 3200 CEDAFi STREET, EVERETI', WA 98201 <br /> 425-257-8810- FAX 425-257-8f357 'I <br /> SITE ADDRESS ?ARCEL TAX I.D.# PERAIIT q <br /> ��oa - i(��� Jr� w , doLE�o��o�o3�loc� � co 3��- ��t� <br /> DESC. LOT NO.��� I BLOCK� TRACT � ���N D ��\/ EJ_T/�7TE J <br /> iJ <br /> OWNER "� ADDRESS �AnwODd ZIP PHONE <br /> T'cNANTryAME �I �/I`.' In�, I�IDCONT�TNASpr�n � wav ��a9aPH0ya��3�C�✓-/J <br /> 3�-�-5).�5 <br /> I Ll�l� �r�,a�� �ya��3�-��lal.� <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE p <br /> PHONE s��}1C C�1�C1�k-03�NG <br /> a�� <br /> PROPO�ED USG OF BUILDING `{� Building �Mechanical Additior� HEAT SOURCE <br /> �� � PERh11T ��� Combination Plumbing WORK Al,era;ion _D Eledric <br /> r� � TYPE �� Demolition Sign 'rvPE .,New �9.Gas <br /> ' U Sprinkler RepaidMaint �U Other <br /> CGNTRACT PRICE OF WORK D J �7� � — CITY OF EVEREfT LOCAL SALES TAk COpE IS 3105 <br /> /� G <br /> WORK DESCRIPTION / <br /> i /(`(.; ,i yl%:/t/ ;G- <br /> PLUMBING ItrECHANICAL <br /> NO. I TYPE OF FIXTUHE OR ITEM N0. TYPE OF FIXTURE pR ITEM <br /> � WATERCLOSET " A/C—A/HANDLINGUNITS <br /> -�• BATHTUB � FORCED AIR SYSTEMS <br /> � LAVATORY(W4SH BASIN) `' HE4T PUMP <br /> SHOWER UNIT HEATERS <br /> J KITCHEN SINK&DISPOSAL � CLOI'HES DRYER <br /> l UISHWASHER f F'ANGE HOOD <br /> LAUNDRY TRAY I N'ATER HEATER <br /> � CLOTHES WASHER METAL FIREF'LACFJSTOVE <br /> JRINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS ?IPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST F^,M ��' <br /> OTHER OTHER _ __ <br /> � � � <br /> I HEREBY CERITIFY THAT I HAVE REAO AND EXAMINED ThIIS APPLICA?ION AND KP�OW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS Nf'E OF WORK WILL BE CQMPLIED WITH WHEfHEH a�•cCIFIED HEflEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PqESUME TO GIVE AL'i HORITY TO VIOLA7E OR CANCEL THE FROVISION OF AN'i OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOP.A4ANCE OF CpNSTRUCTiON. THAT I HM AUTHORIZED 6Y THE <br /> OWNER OF THI -PROPERTY TO PERFORA1 THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOF LAW 18� 7 CW ANq 296.200 WAC. f ' <br /> \ � � � J� � I i <br /> Signatu o �ne/C ntractor/Aulhorized Agent Date <br /> i DEBIT & CREDI'f CARDS ARE NOT ACCEPTED <br />■-- <br />