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. � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEOAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425257-8857 <br /> SRE ADDRESS PARCEL TAX I.D.M PE �ff# <br /> EV o ,�/0/ l3/�-CY�g <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER IIUDRESS LP PNONE <br /> ����� rs, �P lZo w Fars y�h S f' �rt r„es�n v�lle. �Lor�ofa . �27,0 2 <br /> 7EN C CT FOR PE R PKONE <br /> �' q-�'d Cor�orti-fidh I -f-F►�wur�( lr, :im�rc�,frlA- �25= �G10-5o�0 <br /> CONTRACTAR ADDRE93 ZIP CONTR.LICENSEi <br /> To b�e cle�rrn�hed /��� l _ � /o„�.�u <br /> PHONE � �J-z (,�G <br /> PROPOSED USE OF BUILDING Buiding fl Mechenical ,�t�y Addiitim HEAT SOURCE <br /> CX�cy R�1.�� � PERMR Combinalion �'� Plumbing YYORK Altmetion Electric <br /> v �( R <br /> G o�'' • f �O�,.1� TYPE DeRqliliOfl V Sign TYPE �{ New K Gas <br /> PrppObS� l�G%(r,1 � Sprinkler L/ RepaidnAainL IJ O�her <br /> CONTRACT PPoCE OF WORK �� C D v� CRY OF EVERETT LOCAL SALES TAX CODE 13 3ti 05 <br /> 7 <br /> WORK DESCRiPT10N <br /> Remove � l�ep/ac� fl,t .�xi.r/�hq Ph�rmncy c�ittitsJzihols, Cotme�icf <br /> t�epa�¢i„e���� Ohe-troNY�ihotD L/1�►�'Rfioh. /�e-oi��niie �vn-�o/srs, <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR REM NO. TYPE OF FI%TURE OR ITEM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYS7EMS <br /> LAVATORY(WASH BASIN) � HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNORY TRAY WATER HEATER <br /> CLOTHES N/ASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACY.FLOW PREVENfER GAS PIPING <br /> SINK(SERVICc/BARIMOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT 1 HAVE READ AND EXAMINEO THIS APPLICAT�ON AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> IPROVISIONS OF LAWS AND ORIDINACEo GOVERNING 7HIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL'?1E PROVISION OF ANY OTHER <br /> STATE OR LJCAL LAW REGI'LATING CONSTRUCTION OR THE PERFORMANCE OF CANSTRUCTION. THAT I AM AUTFiORIZED BY TNE <br /> OWN[R OF THIS PROPERTY TO PERFORM THE WGRK FOR WHICH APPLICATION IS MADE AND I COMPLY WRH THE STATE <br /> Ct�NTRACTORS LAW 18.27�RCW AND ��200 WAC. � <br /> —'_'��. ��/(�/Q�' <br /> Sgnature M �r/ �Vacl / n✓zetl Agent Gate �� <br /> DEBiT 8 CREDIY CARDS ARE NOT ACCEPTED <br />