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Hu6 14 06 09:41p �ori R�ynalds 206-364-1299 p. l <br /> �, <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S '" �5-0,(� <br /> 425-257-8810—FAX 425-257-8857 M O 60� �+O?.� <br /> SITE ADDR S PARCEL TAX I,D,k <br /> PERMIT# <br /> LEGA LOTNO. � �D � �� "N/ �� <br /> BLOCK TRACT <br /> DESC. <br /> OWNER , <br /> � � "7 RESS PHONE <br /> � q zo $ �03 <br /> NANTN E CONTACTFO PERMR <br /> PHqNE <br /> �C-r�?d� yzs- ��,5- 8 y 5� <br /> CON CiOR � aDORESS <br /> w�s� ����� �y��,/ LP CONiR.LICENSE y <br /> PHONE C�KJ //� R� �� N I� G�{J�c�f✓IL�.I�'�/((� <br /> ZO(4� Z-$'L �j � <br /> PROPOSED U9E OF BUILDING I Buflding �p�.�'iI eohanical <br /> � Additlon HEAT 80URCE <br /> PERMIT B Combination U PIUrt1bII1g yyp�( g q��ryq� <br /> TYPE D Demolition U Slpn TypE N� I [� Eiactric <br /> U SpAnkler ��� �� <br /> Reps:UMaint. L) ow., <br /> . CONTItqCT PRICE OF WORK � I ' I CITY OF EVERETT LOCAL SALES TAX CODE IS 1106 <br /> WORK DESCRIPTION <br /> G-� � � 1,�� �� �.�. ��- <br /> �- <br /> PLUMBING MECMANICAL <br /> N0. TYPE OF FIXTURE OR ITEM <br /> NO.. IYpE OF FU(7URE OR REM <br /> _ WATER CLOSET(TOILET) _ q/C_,q�fiANDLING UNITS <br /> _ BATHTUB <br /> _ L 4VATORY(WASH BASIN) _ FORCED AIR SYSTEMS <br /> _ SHOWER _ HEAT PUMP <br /> _ KITCHEN SINK 8 DISPOSAL _ UNIT HEATERS <br /> DISHWASHER _. CLOTHES DRYER <br /> _ LAUNDRY TRAY �+NGE HOOD <br /> _ CLOTHF.S WASHER � WATER HEATER <br /> _ URINAL _ METAL FIREPLACEJSTOVE <br /> _ DRINKING FOUNTAIN _ F�REPLACE INSERT <br /> _, FLOOR ORAIN' _ �+S FIREPLACE <br /> ._ BACKFLOW pREVENTER — G��GE <br /> _ SINK(SERVICE/BAR/MOP/ETC.) _ GAS PIpING <br /> OTHER —_ �XHAUSTFAN <br /> � OTHER <br /> I HEREB'I CER�TIFY 7HAT I FIqVE 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 COMPLIE�WITH WI1E7ryER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES N07 PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCFL THE PROVISION OF ANY OTHER <br /> STA7E OR LOCAL LA�V REGULATING CONSTRUCTION OR THF PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TF1E <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CON CTORS LA .27 RCW AND 29620 <br /> 4 �� .� <br /> Si at re of Owner/ ontractor/A i rizad Agent �Date <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />