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ERMIT APPLICAT . JN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE ADDRESS PARCFL TAX I.D.N PERMIT a <br /> 3��e S-g r- 74azrr OosF �/ Jnr 3�v/ a&#S/C- 203? <br /> LEGA. LOT NO. / BLOCK TRACT <br /> DESC $F'/2c�2-/l-U A/' ��?_n9/F��'00 •} <br /> OWNER <br /> ADDRESS ZIP PHONE <br /> 3dZ 4*7 _�"ya j <br /> TENANT NAME I CONTACT NAME PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE M <br /> UcU�r.>2.asE�i�vs.rn. •sa,i3ek3u- vA' a��6vc7FV6Jr <br /> PHONE <br /> PROPOSED USE OF BUILDING Building 6a Mechanical n HEAT SOURCE <br /> PERMIT Combination FL��I( Plumbing WORK R��Iemiotion Electric <br /> �"�� '-'' ��• TYPE Demolition Sin TYPE New Gas <br /> Sprinkler Repair/Maint. Other <br /> CONTRACT PRICE OF WORK Z .D CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i <br /> WORK DESCRIPTION / <br /> �F7.a) sSi A/6 c C=• ��1-.Ni�� �tS i b E.vf.� L�rj c� F,Q�f.r�rC i� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> � - BATHTUB _T FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> / KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER T RANGE HOOD <br /> _ LAUNDRY TRAY �_ WATER HEATER <br /> / CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN �_— GAS FIREPLACE <br /> FLOOR DRAIN / GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I _ <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCPt LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THI OPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS W 18.27 RCW�A,ND,296.200 WAC. <br /> Signature of caner/Contractor/Authorized Agent Date <br />