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t PERMIT APPLICATION <br /> � ,�"� S� � CITY OF EVERE7T PERMIT SERVICES <br /> ��` � 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-8870 — FAX 425-257 8857 <br /> SITEADDRESS,�� �,.��. � ;��i, ,tiu��st:itiun PARCf.LTAXI.D.# PEfib1`T��I� _ �>/ <br /> IO.i? I lU[h I`I, ti' / IY'cst I-5 / Nol'th 11'_tl� �K 0;19 001 UU7 00 ��> <br /> LEGAL 1�OTN0. BLOCK TRACT <br /> DESC. =Cl' ;ILL:ICIiI`�.I <br /> OWNER ADDRESS 21P PHC"iE <br /> I'llll \u_ j nl Snn�iv iah 1'n nt�• I}:II' y�;il� tili� �'vnr�.tt 04�f1T (�):l °Hi- 1SOi <br /> TENANT NAMf: I CONTACT NAME PHONE I <br /> 5vnr ;is o�,ancr I�cnni>; liurmcr;int � l�i?S) 7R.i-�130.i <br /> CONTRACTOR ADDRE55 ZIP CONTR.LICENSE M <br /> Nilsun Cun ;trurtiun Cump:in)' IiDO NlV ThirJ Avc KII.SUC ' _'S.iPti <br /> PHONE �� � <br /> Sll.i :O:i-(,RB� C;inb)' OR ,UI:� � <br /> CROPOSED USE Of BUILOING r) Buildinr� fl Mechanical Adtlilion HEAT SOURCE <br /> PEHMIT D Combin�lion H Plumbing WORK R Allernlion D Eleclric <br /> Ii I �i t P i C:�1 tiubst nt i�m TypE �] Demolil�on V Sign 7YPE D Now L� Gns <br /> U SpKnkler L� Repair/Mainl U Olher <br /> X Pi:'JCf: <br /> CPNTRACT PRICE OF WORK ��� ����� CIIY OF EVERETT LOCAL SALF.S TA%CODE IS 7105 <br /> WORK DESCRIPTION <br /> ,\pprus I9U If ut' ' ft hi}:h ch,�in link sccin•ity (rncc. <br /> A.� shu�.n �,n Uistri�t �i�:�s ti-.ifl-CI , CIO aml CII (att;inc�J) <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTIIRE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> WATERCLOSET _______ NC-NHANDLINGUNITS <br /> BATHIUB _. _ FORCED AIR SYSTEMS <br /> LAVATORV(WASH BASIN) . _ hIE/1T PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSA� ._ CLOTHES DRVER <br /> DISHWnSHER , . � RANGE HOOD <br /> LAUNDRY TR�Y �'lATER HEATER <br /> CLOTH[S WASHER __� METAL FIREPLnCElSTOVE <br /> URINAL __ FIREPL�CE II,:;ERT <br /> DRINKING FOUNTAM __ GAS FIREPLACL' <br /> fLOOR DRAIN � GAS RANGE <br /> DACKFLOW PREVENT[R GAS PIPING \���� � <br /> SINK(SERVICE/BAR/MOPIFTC ) ___ EXHAUST FAN \\ \ <br /> OTHER OTHER__ v � <br /> - � -- --- � - —� ,�oo� � <br /> ---�----- � --- �- --- - <br /> - - -- -- -- -- ----- �- - }��Z�-p <br /> I H[REBY CERITIFY THAi I HAVE R[.1D AkD f XAM WEO THIS APPLICATION AND KNOW THE SAMC:T 8 �AND CORR�I FA��C� <br /> PROVISIONS OF LAWS AND ORIDINACFS Gc�VERNING TNIS TVPF OF WORN Wlll BF COMPUED WIT��THFR SP:�(iEM-4'�'[�EV70R � <br /> h0T THE GRANTING OF A PE-RMIT DO[S NUT PRESUh1E TO GNE AUTHORITV TO VIOLATE OR CANCEL TH[�BN OFYM�OTHfP. , <br /> STAT[OR LOCAL lAW RFGULATING CONSTRU�:TION OR TM[PERfOR61ANCE OF COh.;TRUCTION THAT I A T 1(9Rl�ED BY The � <br /> OWNER UF TNIS PROPERTV TO P[RfORh1 TNE WORK fOR WHICH APP�ICATION IS MA�E AND I C("�PI.1'WITH T TATE <br /> I CONTRAGTORS LAW 18�7 HCW AN0206100 W <br /> I <br /> a�� 1;vj��., �:�l.tvl - t. , � b 17 0�1 <br /> � Signaluro of OwnedConlraclodAu�hor¢nd Ag - — �ale — — --- �., \ <br /> v � <br /> __ _ � <br />