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PERMIT APPLICATIC)N <br />CITY OF EVERETT PERMIT SEFtVICES <br />3200 CEDAR STREET, EVEREIT, WA 9E201 <br />425-257-6810 — FAX 425-257-8657 <br />SITE A�DRESS PARCEL TAX I.D. # PERM11IT k <br />«,C ' ✓i ��u, co39.7$CDScGiao cosqlBLbscr3oo �� QZ3 <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. ����r d�uS t%iY � Ctl5 D-00 i�o'Y 4 (3LK. S <br />f 1 L <br />OWNER A�DRESS ZtP PHONE <br />���c�l h1 � Cu�u��5 3509 5 har� ✓�-v�e. ��e�ett 9��3 Y�s 34� �i5�`.� <br />�.�� u�c ��-;9 a.54 <br />TENANTNAME <br />iM.L �li�1lS <br />CONTACT NAPdE <br />CONTRACTOR ADORESS ZIP <br />I"��(e �onSV'Yuc.��ovt CJa� 7�.�c. 197oS y'St� {qUt 5c= <br />PHONE f'jQ4-kCC( L1�4. 1$Lil�� <br />PROPOSED USE OF BUILOING fi Building f"1 Mechanical <br />PERMIT � �� Combination �--� Plumbing <br />�inG L�:•�nCS a�+.� w��-Chen TYPE j�.j Demolition LJ Sign <br />Y"6E'4.� �hc{ LavK-�h� C(ySSi-5 l� Sprinkler(aolheaUs) <br />CONTRACT PRICE OF \YOHK <br />WORY. DESCRIPTION <br />�ew�ovC� �i wu.tlS <br />+`�5�-� K�-l-ckrN <br />G.l� l fn$�a � � <br />�t rccL , <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SINK 8 DISPOSAL <br />TRAY <br />_ URINAL <br />DRINKING FO TAIN <br />FLOOR DRAIN <br />BACKFLOW PREV TER <br />SINI<(SERVICE/BA /MOP/ETC.) <br />OTHER <br />CONTR. LICENSE k i <br />f7Q��G �'iCT ��� � ��� I <br />Addition <br />Alleralion <br />New <br />Repair/Maint. <br />HEATSOURCE <br />Electric <br />Gas <br />Other <br />CITY OF EYFRETT LOCAL SALES TAX COOE IS 3105 <br />heu� S.aPf'°�E- b'1:,Hs cis �e,- eia��KecrS SpeL.s i <br />mt�nar <br />N0. I TYPE OF FI7(TURE OR ITEh1 <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />OTHES DRYER <br />RA GE HOOD <br />WAT HEATER <br />METAL IREPLACE/STOVE <br />FIREPLA INSERT <br />GAS FIREP CE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAP�1E TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVFE OF W07K INILL BE COh1PLIED WITH INHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESU�dE TJ GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAV✓ REGULATING CONSTRUCTION OR THE PERFORh7ANCE OF CONSTRUCTION. THAT I AM AUTHORI'LED BY THE I <br />OWNER OF THIS PROPERTI' TO PERFORtd THE WORK FOR WHICH APPLICATION IS MADE AND I COPdPLY WITH THE STATE � <br />CONTR4CTORS LAW 1827 RCW AND 29G200 WAC. I <br />/� <br />