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r – <br /> —;� – <br /> PERMIT APPLICATION <br /> CITY UF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS(-; ��1� ` \��� \ • VV I \)V�\�l.\O\�A 1\\ l�C`\)\ ,. l�O.�X/� '"( /Z� <br /> ��\ <br /> LEGA LOT N0./1, BL�CK 7RACT � <br /> DESC. `�� �� L-.ac�R�► i�c�, C. S'rh'1�''a <br /> OWNER ADDRESS ZIP �PHONE <br /> �� oi �� �.�. R.�C:� � In/L. � � � ��� S/LVCR SrR.�NC�t W/!Y� SrAi/G)0�{�� �/��q. 98zyz <br /> TENANT NAME COiJTACT NAME (c�ZS F�k PHONE <br /> (�1 �A �r.�cCar-�c�ac� s�y •s935 �sy-55�� �`�� <br /> , i 330 –oZ�I z� ! <br /> CC?!TRACTOR A�DRESS ZIP CONTR.LICENSE# <br /> PHONE S(�r� lr- C0�-DC/� O3�NC7 <br /> EKf /o�zz�o 3 <br /> PROPOSED USE OF BUILDING uilding Mechanical Addition HEAT SOURCE � <br /> �– PERMIT Combinati0n Plumbing WORK Alteration Electric <br /> �� � (–�� �� TYPE Demolition �Sign 7YPE �New �Gas <br /> Spfinklef(A of heacls) Repair/Maint. Other �� <br /> CONTRACT PRICE OF WORK CITY OF EVEREff LOCAL SALES TAX CO�E IS 3105 <br /> WORK DESCRIPTION � � � <br /> �l. f�:�_) � ��O (.a � <br /> ���� � Z �� � y �� <br /> PLUMBING MECHANICAL � <br /> NO. TYPE OF FI%TURE UR ITEM N0. TYPE OF FIXTURE OR ITEM � <br /> ' WATER CLOSGT(TOILET) A/C–A/HANDLING UNIT& � <br /> �/. BATHTUB � FORCED AIR S'fSTEMS <br /> i LAVATORY(WASH BASIN) HEAT PUMP <br /> SFIOWER UNIT HEATERS <br /> � KITCHEN SINK& DISPOSAL � CLOTHES DRYER <br /> � DISHWASHER 1 RANGE HOOD <br /> LAUNDRYTRAY � WATER HEATER <br /> I CLOTHES WASHER ME7ALFIREPLACE/STOVE <br /> = URINAL FIREPLACE INSERT ��� <br /> DRINKING FOUNTAIN GA3 FIREPLACE <br /> FLOOR DRAIN I GAS RANGE 1i <br /> _ BACKFLOW PREVENTER � GAS PIPING �O <br /> SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> _ OTHER _ OTHER 1J� � <br /> — i <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAMG TO BE TRUE AND CURRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br /> I STATE OR LOCAL LAW REGULATING CONSTAUCTION OR THE PERFORMANCE OF CONSTRUCTION. ThIAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MApE AND I COMPLY WITH THE STATE <br /> CONTFACFORS LAW 18.27 RCIN AND 296.200 WAC. <br /> j" • � <br /> / i <br /> / /� <br /> ..� n..... . : v;. _ �'_l' 1/ I ��03 <br /> SignaWre of OwnedContractcdF.ulhorized Agent ate ,I � <br /> %L <br />