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PE��MIT APPLICATIC�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE AUDRESS Z1 ZO �� I. C�� '� PARCEL TAX I.D.N PEiiM1T M <br /> w 2804�4 c�Z ao3 ao v ��- O/� <br /> LEGA LOTNO. BLOCK TRACTA" <br /> DESC. � TIq.02 <br /> OWNER ADDRE53 LP PMONE <br /> w�lliro,r, �=✓a�,k i �,� 3�tAw. H� u��ares�k vr� q�"s�� �f>5- � <br /> TENANT NAME �16d}IYG�- CONTACT NAME PHONE <br /> Jo�a��a2� e�m��w,�-t�� �--� 5�u�e �',Ey°e�+-��� 4�'��ZGG� <br /> CONTRACTOH� ADORESS LP CONTR.UCENSE N <br /> PHONE /UI �� � <br /> i v -�- <br /> PROPOSED USE OF BUILDIN(i Bullding Mechenicel Addllion HEAT SOURCE <br /> r r KO � ' PERMIT Combinetion Plumhing WORK Alterallon R Electric <br /> ` 111 n i,.. TYPE Demolilion Sign 7YPE New �J 6es <br /> ��° �� Sprinkler Rapalr/Mainl. U Other <br /> CONTRACT PRICE OF WORK �O� �O CITY OF EVERETT LOCAL SALES TAX COOE I9 3f05 <br /> WORKDE9CRIPTION w�; Q,GC� ,(�1�,(�� �y/�/ ((D u�/./s. p�„Pj, 3�.'�• wl �(fOp� <br /> u. ' ' �c,..A�M�rc�l.. a c+.ne.1 a�ao au1-�+o C r�:��"� cLaru., c`he.AtD� <br /> bn- a/� r�d'�a �akt.,e�s t oCd�d- �'��f �.. �arce,�cd��5ete:c, �2 B�-+'�` . <br /> t � �, �freef- ina• � cti'r"a - �3 <br /> PLUMBING MECHANICAL <br /> INO. TVPE OF FU(TURE OR REM N0. TVPE OF Fl%TURE OR�TEM <br /> � _ WATER CLOSET __ A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> i _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> DISIiWASHER RANGE HOOD <br /> LAUNDRY TFAY WATER HEATER <br /> CLOTHES WASHER METAL FIFiEPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN pAS FIREPLACE <br /> FLOOR DRAIN OAS RAN4E <br /> BACNFLOW PREVENTER _ GAS PIPING <br /> SINK(SERViCE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBV CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PPOVISIONS OF LAWS AND OFIDINACES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED WITH WHETNEH SPECIFIED HEREIN OR <br /> NOT. THE GFANTING OF A PERMIT�OES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BV THE <br /> OWNER OF THIS PROPEFTY TO PERFORM THE V/OFK FOR WHICH APPUCATION IS MADE ANO I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1 . RC ANO 298.200 WAC. <br /> �J�Q� <br /> Signa re ol wned on ac1 iAulhonzed Agent ate \�L <br />