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P�RMIT�APPLiCA`�ION <br /> CITY OF EV�R�1T PCRMIT SERVIC�S <br /> 320J CEDAR STREET, F:VFRETT, WA 98201 <br /> 425-257-6810— FAX 425-2E7-6057 <br /> , <br /> �u ;����..C.S_Z <br /> SITE ADpR SS � PARCEL TAX I.D.Jf ����� PERMIT N � <br /> �-1�c "I�ILw�� `�. � � � C`!\ � �.�.L!—_ �Lo>��� ��-�,3 <br /> LEGA LOT NO. If!� BLOCK TR CT (' �\� 1 r lt <br /> DESC. lV ��f.,\�i�`�CA-�-�-�, ���"\V�1t --- <br /> OWNER ADDRESS ZIP PfiOIJf- <br /> Cc�t� Cycr.�.�tic. .\�����,��vcQ_5�������a��l.� w��;��w� ��;�.�`�,.: <br /> TENANTNAME CONTACTNAME (��a5> �-nk PHONE `�l` <br /> 1��� I��LC �a�\��� 3�-\�r}�__�� '�?J-l.r�`l�C� 'S�.�()��111��L <br /> CONTRACTOR � ADDRESS � ZIP CONTR.LICENSE A <br /> � l�u�U�G3�.h�i� <br /> PHONE � <br /> .,�ME ' Ek�?. lol�alo:� <br /> PROPOSEO USE OF BUILDING Building �Mechanic8l Addltbn HEA7 SOURCE i <br /> „ PERMR ��Combinatlon Plumbingj IWORK � Alterallon �Electrlc I <br /> S '� � TYPE Demolilion Sign 7Yae r�ew oas <br /> Sprinkler(N ci haeds) � � Repeir/M�int. Olher <br /> COGfTRACT PRICE OF WORK � . CITY OF EVEREfT LOCAL SALES TAX CO�E IS 3105 <br /> i <br />� WORK DESCHIPTION • , :...j•. '� <br /> .�\ \ '1v .\\�V i I <br /> ����C a��`�0 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR REM � NU. �TYPE OF FIXTURE Ofl ITEM <br /> WATER CLOSET(TOILET) A/C-FVHANDLING UNITS <br /> BATHTUB = FORCED AIR SYSTEMS <br /> ,� LAVATORY(W4SH BASIN) _ HEAT PUMP <br /> SHOWFR UNIT HEATERS <br /> _� KITCh1EN SINK 8 DISPOSAL = CLOTI�IES DRYER <br /> _� DISHWASHER _j_ RANGE HOOD <br /> LAUNDRY TRAY �_ WATER HEATER <br /> S CLOTHES WASHER METAL FIREPLACE/STOVE <br /> _ URINAL FIREPUICE INSERT <br /> URINKING FOUNTAIN � GAS f�iREPLACE <br /> FLOOR DRAIN � GAfi f'IANGE <br /> BACK�LOW PREVENTFR GAS F IPING <br /> SINK(SERVICE/BAR/MOP/EiC.) - EXHAUST FAN <br /> OTHER_ __ _ OTFiEq <br /> I HEREBY CERITIFY THAT i H/1VE READ AND EXAMINED THIS AP('LICATION:,�JD KNOW TI!E SAM[TO BE TqUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND Of11DIIJACES GOVERNING THIS TYPE OF WORK V:ILL BE C01.7PLIED WITH WHE7HER SPECIPIEO HEREIN OR <br /> �� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIO'v1TE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRL'CTION OR THE PERFORMAA'CE OF CON;;TRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER THIS PROPEFTY TO PERFORM THE WORK FOR WHICH APPIICATION IS MAO[AND I COMPLY WITH THE STATE <br /> CONT C RS LAW iB.27 HC AND 296200 WAC. <br /> ������ ��!(o�3 <br /> Signaluro o OwnedCoMractodAuthonzed Agent Dale <br />