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I ERMIT APPLICAT, )N <br /> O:Jlr CITY ;F EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257.8810 - FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D. x PERMIT x <br /> "- I 1 I G I S+ 1 5vycl -oo/ coo 7-b1 o <br /> LEGA LOT NO BLOCK TRACT /I 1, <br /> DESc. I2.. i"I 11c �I�fSY Lr viSt0Vl A Acc•i ), TA?Tv��/r. ;(c�a <br /> Fl�r <br /> OWNER ADDRESS ZIP PHONE <br /> vN r)-i S I ' ? ISI 61 5+ E'vEre� � wr4 2v > � Y <br /> .,,� � 1i5-7cle-S�S� Nn�..; � <br /> TENANT NAME I CONTACT NAME PHONE J <br /> �P5• -� �"'`�Ir�� I7 •' sxvt /1-tS•Ert �`li VIZs -7 �10S1 �,' ti� <br /> CONTRACTOR 11fA,C7-1 .40 -rk'D, ADDRESS 16.73-d,241PAvB f LP CONTR.LICENSE <br /> PHONE .;253 -1356- q 1" F7 �r LrJfl• �a'�'�/ �EA/tT// /oi KJ <br /> FqX -11133 <br /> PROF jSED USE OF BUILDING rBU <br /> i"Ingf"1 MechanlCal Addition NEAT SOURCE <br /> PERMIT Combination 1LH-Jt Plumbing WORK AlleraUon (7 Electric <br /> TYPE Demolition Sign TYPE New Gas <br /> Sprinkler Repair/Malnt. Other <br /> CONTRACT PRICE OF WORK 62 bY, `i b d Til ar s5 7. 94 CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> TorAt sGs.2b• `ir <br /> WORK DESCRIPTION B1`; /C-/, ,.9 4 -/ <br /> /vo p/wµ• b'^7 €I -' ��oc >lR%cam <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET A/C-A/HANDLING UNITS <br /> _ BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNIT HEATERS <br /> _ KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> _ DISHWASHER 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 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 LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTO S LAW 18.27 RCW AND 295.200 WAC. <br /> Signature o wnerl onlractorlAuihodzed Agent Uale / <br /> L <br />