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1 <br />PERMIT APPLICATION <br />CI'TY OF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, EVERETT', WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />2�� � <br />SITE AD�RESS <br />LOT NO. <br />I�-rs�-� 1,�� <br />PARCEL TAX I.D. # <br />GLOCK � TRACT <br />672v r ,2T+�.rr w�-Y <br />TENANTNAME CONTACI�FURPERMR <br />N1�� Y ��E-�" `S �#.� W r�-1 <br />CONTRACTOR�J� �d� .� <br />��� � ��r <br />rHowe ZD1�ZZ311' <br />PROPOSED USL OF DUILDING <br />�`�z�, <br />ADDRESS <br />1� �� q-zH A-� . S , <br />s��,� . c.� �� ( :• <br />PERNIT # <br />Zo622-'� 1 � <br />ZIP CONTR. LICENSE q <br />�'-' f3�'l4aJ�31 <br />�uilding Mochanlcal AdCllion NEATSOURC[ <br />pBRMIT R Combination B�'lumbing WORK�Iteretio,� D Eleddc <br />TYPE Uomolitlon O�SIgn TYPE ew L7 ca9 <br />Q Sprinkler RepaidMainl. U Olher <br />CONTRACiPRICEOFWORK I`S��OOb. <br />WORK DESCftIPTiON <br />i N S-ua �.1. 4 b� u� Stl�,r-� S <br />� N0.— � —lYPEOF�IXTURC-ORiT[M�----�--�-"�"�� <br />WATER CLOSG7 (TOILET) <br />---- BATH7U8, --�— ^—_�._.T___--- <br />ZAV.�TaRY(WA�F7�A <br />SI10W8R <br />KITCHBN SINK & DISPOSAL <br />DISI iWASfi[R <br />111U NDRY TIZAY <br />CLOiHES\NASHER <br />URINAL <br />DRINKING FOUN7AIN <br />FLOOR DRAIN • <br />OAG<FLOW PRC-VENTER <br />SINK (SEfiVICEiBAWMOP/ETC.) <br />OTHER <br />� <br />CITY OF CV[RETT LOCAL SAL[S TA% CODE IS 9105 <br />��F ����uw�a�r SrGnI <br />NO: t I—TYPEOF FIXTURE OR 1TEM -- -�-- <br />-AMANDLING UNITS <br />iCFO AIR SYSTEMS----- -- - ' " --" <br />UNIT HEATERS <br />CLOTIiES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPU�CUSTciVE <br />FIR[PLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PI"ING <br />EXHAL57'PAN <br />OTHER <br />I HEREOY CHRITIFY TI1AT i HAV[ READ AND E%AMINEO THIS MPLIClSION AND KNOIV THE SAMG TO �F TRUE ANO CORRECT. Al!. <br />PF20VISICNS OF 111WS AND Of21UINACES GOVERNING THIS TYPE OF WOFI<N'ILl �E C0�1PLIE0lYITH WHETHGR SPECIFIE� IiEREIN OR <br />NOT. THE GRl�NiING Of A P[RMIT UOES NOT PRESL'A7E TO GIVf AUTHORITY TO VIDLATIc OR CANCEL THG PROVISIO� OF ANY OTHcR <br />STATE OR LOCAL V1W REGULATING CONSTRUCTION OR lHH PGGFOR6IANCE OF CCNSTRUCTION. THAT I AA1 AUTHORIZED 6Y 7HE <br />OINNER OP THIS PROPGRTY 70 PGRPORM THI? WORK FCR WHICN APPLICAI"ION IS fdA�[ AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 10.27 RCW AND ^s96 c"Bt?N'AC. , <br />& CREDIT CARDS ARE NOT ACCEPTEp <br />