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i — <br /> PERMIT APPLIC�ATION � ' <br /> CITY OF EVERETT PERM17 SERVICES � <br /> 3,?00 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE ADDF���� \�� I pqRCEL TAX I\.q P IT H <br /> �` t �\(,�.�.�� � �l -617 <br /> LEGA LOTN�ry BL CK TR�n CT . <br /> DESC. S ��. L.a�a a �J Px."7'z Ls i i4�z-c I <br /> OWNER A�DRESS ZIP PHONE <br /> C n�-oC �,� �. I y � O 5���� SP2„�GS ��/ny, S,-nNwa�� , u/a . 9Bzg2 <br /> rz�zs,�, <br /> TENANTNAME i <br /> CONTACT NAME ���_� G��ONE C�.`L <br /> N /� � ��E (�(Z�Tb(`�jL� � 3y-5 935, 33Y- 5`/3l.� 33o•zN7,.�,, <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> PHONE �AY•.�" GO(. �PGI �'f7�i' �1'L7 i <br /> �y�' /a/Lz�o 3 <br /> PROPOSED USE OF BUILDING Building Mechanical Addition HEAT SOURCE <br /> S /J � O PERMIT Combinalion � Plumbing WORK IR-.( Alteration Electric � <br /> � TYPE Demolition Sign TYPE �}New ��S � <br /> e � <br /> Sprinkler(k o!heads) U Repair/MairL Other �. <br /> CONTRACT PRICE OF WORK CITY OF EVERETf LOCAL SALES TAX CODE IS 3705 <br /> WORK DESCRIPTION <br /> ���'r-� 1Z,2�3 <br /> �J�s,c. �.l `� � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITC-M <br /> i WATER CLOSET(TOILET) _ q/C—A/HANDLING UNITS <br /> � BATHTUB _ FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> � KITCHEN SINK 8 DISPOSAL 1 CLOTHES DRYER <br /> �_ DISHWASHER � RANGE HOOD <br /> _ LAUNDFiY TRAY � WATER HEATER <br /> _ CLOTHES WASHER _ MFTAL FIREPLACE/STOVE <br /> _ URINAL _ FIREPLACEINSERT <br /> _ DRINKING FOUNTAIN _ GAS FIREPLACE <br /> _ FLOOR DRAIN 1 GAS RANGE <br /> _ BACKFLOW PREVENTER 1 GAS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) 3 EXHAUST FAN `L� <br /> _ OTHER OTHER O <br /> _ _ � ��i. <br /> � <br /> I HEFEBY CERITIFY THAT I HAVE REAG AND EXAMINED THIS APPLICATiON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVIS!ONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL 9E COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTIIJG OF A PERtd1T DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW RFGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED dY THE <br /> OWfJER OF THIS PROPERN TO PERFORM THE WORK FqR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTR ,C flS LAW 18.27 RCW AND 296200 WAC. <br /> � ��fta�.ft �Q ��/c.�U3 <br /> SignaWre ol Own�dContraclodAuthonzed Agent '� Date <br /> `/i <br />