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� — — <br /> . PERMIT APPLICATION <br /> ; CITY OF EVERETT PERMIT SERVICES <br /> 1 3200 CEDAR STREET, EVERETT, WA 98207 <br /> � 425•257-8810-FAX 425-257-8857 <br /> ISITE ADDRESS PARCEL TAl(I.D.N PER �7 M <br /> lool W C�I►�o �9 P�r.�� . b oG�-3 O00000 00 �' - � � <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. � � <br /> � OWNEN AODRESS ZIP PHONE <br /> �I�Tb flN4K- HOM1E OwMQtS lool W C�SIUORD if 92ttL ¢25 s13 '�3'bt <br /> /k�'�oc�,•�'T+ors� �o tca��tiuwski t-�En,E'if � W k 9B2o4 <br /> TENANT NAME I�a N ACT�FI)�ERM�I��� Zd��?8� ...�5� <br /> ?�4UFlG �N(o11JCE}CINfo `f�C�l._ <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE p <br /> 'iro 'P�E �'t�H^ ��� �'t F31 D p12.o C655 <br /> PNONE <br /> PROPOSED USE OF OUILD,IING �uilding n Mechanical I AdOition HEAT SOURCE <br /> R-� �udOm�N�-`� p[RMIT � Combinalion H Plumbing WURK � �Ileration [� Eleclne <br /> TVPE Demolilion LJ Sign TYPE New Il4 Gaa <br /> Sprinkler RepaiUMninl. C_j Olher <br /> CONTRACT PRILE OF WORH d t�50�/�pQ-� CITY OF EVERETT LOCAL SALES TA%CODE IS J105 <br /> Y <br /> WORK DESCRIPTION <br /> Sc-k �4'[T�tckf�D <br /> PLUMRING MECHANICAL <br /> NJ. TYPE OF FIXTUHE('F I�E�d NO. TYPE OF FIAiURE OR ITEM <br /> VJATFR CLOSET A!C-A/HANDLING UNITS <br /> �ATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH �ASiNI HEAT PUMP <br /> SHOINER UNIT HeATERS <br /> KITCHEN SINK R DISPOSl�L CLOTHES DRYER <br /> DISfiWnSH[R RANGC HO00 <br /> LAUNORY TF2AY WATER HEATER <br /> � CLOTHES WASH[R METALFIREPLACElSTOVE <br /> � URINAL FIREPIACE INSERT <br /> � DRII:KING FOUNT�IN GAS FIREPLACE <br /> FLGOR DRAIN GAS Rl�NGE <br /> OACKFLOW PREV[NTLR GAS PIPING <br /> SINK(SFRVICE/BAR/I.fOPIETC.) EXHAUST FAN <br /> OTHER___ _ OTHER _ <br /> I HGREOV CERITIFY THAT I H�V[REAO hND EXA'.1U:FU THIS APPLICA710N AND NNOW TME SAA1[TO OE TRUE AtJD CORRECT. ALL <br /> PRGVISICY.S OF L'.175l.h0 OPoUINACCS GOVCRWIIdG THIS TYPH OF WORK WILL BE COAIPLIED WITM WHETHER SPECIFIE�HEREIN OR <br /> t�OT. THE GMNTIhG OF A PER1dIT DOES AbT PRESUAfE TO GIVE AUTHORITY TO biOLATE OR CANCEL TH[PROVISION OF PNV OTHER <br /> S7ATE OR LOCAL LJdY RLGULATR:G CONSTRUCTION OR THE PERFORh1ANCE OF CONSTRUCTION THAT I AM AUIMJRIZED BV THE <br /> O'�fN[R OF THIS PROPEftTV TO PERFORh1 THE 1VORN FOR K'HICH APPLICATION IS�1ADE AND I COAIPLY IVITH 7HE STATE <br /> CONiMCTORS LAAY�P '.1 RCPJ l�t:D 79G�J01VAC <br /> S�' �/1• ���Z'0�.� G�'�G.�i�',r2G� (o AK)I/.0� <br /> � Si9n�!ure ol Own r� ontracio�/�ulhonzetl Agenl Dele / <br /> � DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED ` <br />