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PCrtMIT APPLICATII�iJ <br /> CITY OF EVERETT PERMIT SERVICES ,Cj�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �C�I <br /> 425-257-u810 - FAX 425-257-8857 ��l() � <br /> SITE ADDRESS PARCEL TA7(I.D.p , PERMi7 a <br /> 715 //0��1 �.�L �l� v��- � ' f�C�<�C,C� `20 � � � -- �p <br /> LEGAL LOTNO. � BLOCK TRACT <br /> i/ <br /> DESC. r'� r � i� �'�� ^� A � � ` '1 l� <br /> OWNER ADORE S ZIP PMONE�zs ]�ZC7 <br /> 5:/_rviE rC.A�I�OSVE2/L .('3 fS s7�GYhl�1/: �ervD �80/Z <br /> tEhANT NAME I CONTACT FOR PERMIi PHONE <br /> CONTRACTOR ADURESS ZIP CONTR.LICENSE N <br /> 5'�_vc �.r�N�F�i� CAysT �-�i% - 3"r,ecrr�nir ,�,1, _r;EcETLoSi-�K <br /> PHONE <br /> (Qzs��y -zo7z � Fl� t��g f��iz <br /> PR OPO SED U5E OF BUILDING ui Mechanica� Addltion I HEAT SOURCE <br /> � .1 PERMIT Combinatlo1lJ� Plumbinp WORK PJteration Electnc <br /> ��'j' f Sr � TYPE Oif ion U �ign TYPE e a <br /> Spnnklef Repair/Maint. Olhr.r <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> PlORK DESCRIPTION ' �' <br /> �t/«� 5�..�' ��fsscL r�— t�- `/;,�' <br /> ? c� �v.L �'�A,�'NC�� � 2 � <br /> �:� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM N0. 'YPE OF FIXTURE OR ITEM <br /> � WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> � �ATHTUB � FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) _ HEAT PUMP <br /> y__ SHOWER UNIT HEATERS I <br /> � KITCHEN SINK S DISPUSAL � CLOTHES DRYER <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> �_ CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING�OUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER � GAS PIPING <br /> SINK(SERVICE/BAR/MOP'ETC,) � EXHAUST FAN <br /> OTHER OTHER <br /> — — � <br /> — — — I <br /> I <br /> I HEREBV CERITIFV THAT I HAVE RE�D ANO ExP.MINED��HIS APPLICATiON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL �i <br /> PROVISIONS OF LAWS AND ORIOINACES GOVERNING THIS TYPE OF 1RORK�VILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT�70E OT PRESUME TO GIVE AUTr�ORITV TO VIOIATE OR CANCEL THE PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGULATW C STRUCTION OR THE PERFORMANCE OP CONSTRUCTION. THAT I AM aLTHORIZED BV THE I <br /> OWNER OF THIS PEf2TY 7p P F RA1 THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTOR .N 18.:7 RC1Y. ND Z9d200 WAC. � <br /> � —� <br /> Sig re o1 _ontracto or¢ed Agent Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED 1'Z I <br />