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PL.�MIT APPLICATI4. J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS �PARCEL TA%I.D.A PERMiT� <br /> �so io �,-,� p� s�� 1Cr��-csd,� <br /> LEG? LOTNO. BLOCN TAA�T <br /> DESC <br /> OWNEH ADDRESS ZIP PMONE <br /> PD,2 c�me/�2�s e� <br /> TENANT NAME I CONTACT NAME PHONE <br /> CONTRACTOR �8���� p�,�,�L �ti,� ADORESS LP CONTR.LICENSE� <br /> ,95ao is✓rn� .Jr� n.E 9�zz3 �eo6��vr��Fz�:-c2. <br /> PHONE (3�d f yo3- �Y62 �� <br /> PROPOSEO USE OF BUILDINO Building � Mechanica� n Addition HEAT SOURCE ���, <br /> PEHMI"f Combinalion Plumbing WORK � allaralwn R ElectrK <br /> S�R TYpE Demolitlon Sign TVPE jdlNow �/ Qes <br /> Sprinkter L! RepaidMaim. � L) Oiher <br /> CONTRACT PRICE�F WORK C�TV OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> -{�yzoo <br /> WORK DESCNIPTION <br /> /�vSTAc. F��'C SP.ei�-�'���s ��`�' �/� SF� <br /> PLUMBING MECHANICAL <br /> Np, TVPE OF FIRTURE OR REM N0. T:PE OF flXTURE OF ITEM <br /> WATER CLOSET _ A/C—FUHANDLING UNITS <br /> BATHTUB _ FORCE�AIR SVSTEMS � <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER _ iiANGE HOOD <br /> LAUNDRY TRAY _ WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPIACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DHINKIN(3 FOUNTAIN _ 13AS FIREPIACE <br /> FLOOH DRAIN _ GAS RP.NOE <br /> BACKFLOW PREVENIER _ GAS PIPING <br /> SINK (SERVICE/BAR/MOP/E7C.) _ EXHAUST FAN <br /> I _ OTHER _ OTHE!� <br /> i = f� — </�,Zir�cL.�Y Nt�l4Q$ <br /> I HEFEBV CERITIFV THAT I HAVE READ AND ExAMINED THIS APPUCATICN AN�KNOW THE SAME TO BE TRUE AND COFiiECT. ALL <br /> ' PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITM WHETHER SPECIFIED HEREIN OR <br /> ' NOT THE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE AUiMORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br /> � STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION THAT I AM AUTMORIZED BV TME <br /> OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WMICN APPLICATION IS MAVE AND I COMPLV WITM THE STATE <br /> CO�ITRACTORS LAW 1 RGW 296 200 WAC. <br /> �1..�' �-/�/,�z <br /> Signelur of w� onlraclor/ uthonzeJ Agent e e � <br /> I a <br />