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PrRMIT APPLICATI <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 RMIT# <br /> 9q0 g +-r ore L266 -03,9 <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OW �-a ADDRESS pot OH, Z 84 �� ZIP2 2 PHONE <br /> r fjL -Q JI .o v cttePei-f BWO 0'06 W,ISeei*7E1/ccc- a 06- 33 C al2-C <br /> TENANT NAMES <br /> 'M i clhCONTACT FOR PERMIT PHONE <br /> ,e , l£. atr\ ce i c-V\Y )I-e La 11, ce Q ©CQ. d-71 3S`2 <br /> CONTRACTOR FosTC� L.ay,b trAl ADDRESS &D l t.2AG4 d AC, ZIP CONTR.LICENSE# <br /> PHONE LZ�Zcitti a;4)497;est ggzoG Fare-4083 Q <br /> �z r z5z �� 3g0 D..7 9/ � - <br /> PROPOSED USE OF BUILDING Building Mechanical Addition HEAT SOURCE <br /> PERMIT Combination Plumbing WORK Alteration n( Electric <br /> C (� TYPE Demolition D Sign TYPE New V Gas <br /> 0-C"c`e-Q41„se_ Sprinkler Repair/Maint. u Other <br /> CONTRACT PRICE OF WORK /600 0,s, I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION p0� _- MAO- w� Tiea,.yo s/ ' ' - lydDfa d crn Si , Ji>✓ ' .- , is 5/it ki <br /> :fins7o9-t1 t. ,+ <br /> v'l e 3-' ' / S/ k.- aid 2.. - " `04 valve' IL ES : o ilftle lve aid ere_c-,44, €,A <br /> PLUMBING MECHANICAL <br /> NO. TYPE 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 TR'Y WATER HEATER <br /> CLOTHES ASHER METAL FIREPLACE/STOVE <br /> -INAL FIREPLACE INSERT <br /> D- KI' G' FOUNTAIN GAS FIREPLACE <br /> 2. FLO'- DRAIN _ GAS RANGE <br /> BA' SW PREVENTER GAS PIPING <br /> S K(SE- CE/BAR/MOP/ETC.) EXHAUST FAN <br /> 9. ,, aTHER 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 I 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 W 18.27 RCW AND 296.200 WAC. <br /> e. c, / <br /> , l� —off <br /> Signature of Owner/Contractor utho `'2rized Agent Date <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED a <br />