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PbMIT APPLICAT& <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 TAX I.D.p P IAIT N <br /> 1w eol Sr S•w 4�22u 2- 00d4 / 20030 il100 <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER �J ADDRESS ZIP PHONE 2UL <br /> SC/Y V( vNt/S d"0 L•iATE I GCC /SU/ Al. 2LW11119 TjMRwA E9t+lr3 3'j� ^ 2 9/ <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> 'eM Mlu 11�ukk [tC I fWA42'ry M,9R��.ti� �zs .ass �y r� <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE N <br /> rnmJ»AS /n/l✓� Tri t s 20 3•Y•2 �C ,env Sr <br /> PHONE /&.OtM7 +NO �l//) 9NU f3 ?HaMAT2072O9 <br /> 4-2 .f �L� ^ 7 7 rf� / <br /> PROPOSED USE OF BUILDING Building Mechanical Addit HEAT SOURCE <br /> /.N�QrAR OdO�� PERMIT Combinallon Plumbing WORK Mlera0on R Electric <br /> TYPE Demolition Sign TYPE New I._j Gas <br /> M/LL-LLJO/CK Spnnkler Repatr/Malnt. LLJJ Omer <br /> CON-RACT PRICE OF WORK 0 CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION / <br /> i•vrrftL ,f-ri u,v or S-OA.47 evv7N <br /> M/f7t uP S Y rrsr/ <br /> PLUMBING MECHANICAL <br /> NO. IYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> _ BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNIT HEATERS <br /> _ KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> _ DISHWASHER _ RANGE HOOD <br /> _ LAUNDRY TRAY WATER H:ATER <br /> _ CLOTHES WASHER METAL FIRE-*PLACE/STOVE <br /> _ URINAL __ FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN GAS FIRErI.ACE <br /> _ FLOOR DRAIN GIS RANGE <br /> _ BACKFLOW PREVENTER GA.::JIPING <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 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.2A WAC. <br /> lyl�� L2 r✓ �cr S- 20o/f. <br /> Signator of 0 ner/Contractor/Authonzed Agent Date GD <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />