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� --- —� — <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ; <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ' <br /> 425-257-8810- FAX 425-257-8857 <br /> � .��—oy <br /> SITE ADDRESS ) PARCEL TAX I.D.# I PERMiT a I <br /> � C� ��h11��� LL`N{� f�� j(� J � �d � ��0- �� � <br /> LEGA LOT NO. � BLOCK TRACT <br /> DESC. <br /> OWNER ADOR[SS 21P PHONE <br /> �1�L�C �IN .�.i['��1� �; 2� ��611�`� � ��Ff/� ��� c�.�� `_� � .i��c7( ��L[�'1 �J-�'��70-`D�ly�f <br /> TENANT NAME CONTACT R PERMIT PHONE <br /> ! <br /> �h� y� �N �1 i�lr��'G�f �iY-(�/' `y���l�-_ <br /> CONTRACTOR ADDRE�S ZIP CONTR.LICENSE M <br /> PHONE �ln MD /i , <br /> V//�/CJ <br /> PROPOSEO USE OF BUILDING pERM17 � Spr nkleation U Plgmbingal WORK � Repaair/Main�, HEAT SE QRCE <br /> NPE Domolilion U Si n 7YPE New Gas <br /> Other <br /> COhTRACT PRICE OF WOHK CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 <br /> WORK DESCRIPTION <br /> ,��r.t/�rm� /�,e�,��e,� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUFE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � " WATER CLOSET(TOILET) _ A/C—A/HANDLING UNITS I <br /> BATHTUB _ FORCED AIR SYSTEMS I <br /> � LAVATORY(WASH BASIN) _ HEAT PUMP I <br /> � SHOW[R _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGF. HOOD <br /> LAUNDRY TRAY WA'(ER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br />' URINAL FIREPLACEINSERT <br />� DRINKING FOUNTAIN _ GAS FIREPLACE <br /> rLOOR DRAIN GAJ RANGE <br /> BACr(FLOW PREVENTER GAS PIPING <br /> ' SINK�SERVICE/BAR/MOP/ETC.) EXHAUSl FAN <br /> OTHER OTHER <br /> I i:ERERV CERITIPV THAT I HAVE READ AND E%AMINED 7HIS APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF U1N/S ARD OR!DIMACES GOVERNING THIS Tl'PE OF WORK WILL BE COMPLIED WiTN WHETHER SPEC:FIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TG GIVE AUTHORITV TO VIOLA:E OR CANCE�THE PROVISIOk OF ANY OTHER i <br />� STATE OR LOCA WW REGULATING CONSTRUCTION CR THE PERFORMANCE OF CONSTRUCTION. THA1 I AM AUTHORIZED BV THE <br /> � OWNER OF rH PFOPERN TO PERFJRM THE bVORK FOR WHICH APPUCATION IS MADE AND I COMCLV WITH THE STATE i <br /> � COIJTRACTOR LAW-iH.]RCW AND�96200 WAC. i <br /> '� � (p��`��b I <br /> a ure wnen nir or/Authonzed Agent Dal6 ' ' I/� ! <br /> � DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED � I <br />