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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 /> SITE ADDRESS PARCEL TAX I.D.M PERMI7 r <br /> �q o2 ��.�. c� � ��Z <br /> LEOA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER AODRESS aP PMONE <br /> ��C.K �lt/Ac..Kt2 29C1L lt.�?j)?Glt� �T `��lLV ��� 258-3sraZ <br /> TENANT NAME CONTACT NAME PHONE <br /> ��s (�y� I�� 4VAC�cz- (42S) 2S8- 33�Z <br /> CONTRACTOR ADDRESS LP CONTR.LICENSE� <br /> � �M� ��cc�.� I�l� Ibci C. t�Ae,�.c= Uie►.� �- 9`�i ev�a.�ssozzoi— <br /> PHONE <br /> 4Zr' 252- 3/l4 <br /> PROPOSED l'SE OF BUILDING Building h��Chd.7iCal Adtlition MEAT SOURCE <br /> I PERMR � COmbination � Piumbing WURK B Alleration �laetnc <br /> u,�_�— �tl TYPE Demolition Sign TYPE ❑ Naw Gae <br /> f�JMTK Uu3 Sprinklar U RepaiUMain�. ORsr <br /> COHiRACT PRICE OF �IYOR 7� � �� CRY OF EVERETT LOCAL 9ALE3 TA%CUOE 19 7105 <br /> WORKDESCRIPTON ���,,,SK i Zu9Ck(1- (7) �F�P Ur.�rS cbw.plL�ru.� l�act�.+aa.�ci La�lv.cts� <br /> �Si�pN6, �,T�uVTi�N-1 tRrJ �Q2 LOcxOL Yc.�y�t $ '('O��r QLwN�Is <br /> PLUMBING MECHANICAI i <br /> NO. TYPE OF FlXTURE OR REM NO. TYPE OF FlXTURE OR ITEM I <br /> WATERCLOSET � A/C-A/HANDLINGUNITS I <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEFT PUMP <br /> SHOW ER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOS.4L CLOTHES DRYER <br /> DISHWASHER RANGE fi00D <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN � GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PAEVENTER � GAS PIPING <br /> _ SINK(SERVICE/8ARlMOP/ETC.) � EXHAUST FAN <br /> GTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE iiEAO AND EXAMINED THIS APPLICATION AN�KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING TMIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GPANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OI=ANY OTHER <br /> STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORt2ED BV THE <br /> OWNER OF T S PROPERTY TO PERFORM TNE WORK FOR WFiICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRA O S WW�8. RC�D .2�Q WA <br /> � 3-/z— ov <br /> SignatU�e of Owner/ContractouAulhonzed Agenl le �/ � <br /> � <br />