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t�pl-'-200o OE:30 FF'LI�I:PERI4IT 4c`_•�75631� T0:14252578657 <br />PERMIT APP�ICATION <br />CITY OF EVERETT PER,MIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25'J-8810 - FAX 425-257-8857 <br />SITE ADDRESS <br />LEGAL �OTNO. <br />DESC. <br />OWNEH <br />TENANT� <br />PARCEL TAX I.D. k <br />c�os3 ozmS�ao <br />TRACT <br />:�� �y'�a <br />CONTACT FOR PERM1IIT <br />��1 C�� <br />P.2 <br />PER�d1T p <br />���) 4�C4 C' L J <br />��� ��3 s�L�-3r3 Z� <br />PHQNL <br />y-.S 27�' 8 w�� <br />CONTRACTOR ! ADDRESS <br />w Rs+� �-��� �v1C�J � ✓ <br />PHo�(a ZB L Y %Gt� � �c�=Pn.�� ��l � <br />PROPOSEO USE OF BUILDING <br />S� <br />n Oullding Mecl <br />PERMIT [] Combinallon Plurt <br />TYPE �� Demolition Sign <br />L) SVrinkler <br />ZIP CONTR. I�CENSE p <br />E�15`J'fr'i�.f'9�� c�g <br />Adairlon HEATSOURCE <br />WORK S aleratlon �lectnc <br />TYPE f} Ne:v as <br />•y.�.+�e pa int.1 aln t. Other <br />CONTRACT PRICE OF WORK � _ ' CITY C� EVERETT <br />�, I <br />WORK DESCRIPTION �� �� f� _ ^��NA! <br />�� ���- �� r�.-� <br />PLUMBING <br />NO. I TYPE OF FI%TURE OR ITEh1 <br />WATER CLOSET (TOILET) <br />BAIHTUB <br />LAVA1 URY (WASH �ASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHN'ASHER <br />LAUNDRI'TRAY <br />CLOTHES WASNER <br />URINAL <br />DRINKIlJG FOUNTAIN <br />FLOOR Df2AIN <br />BACKFLOW PREVENTER <br />SIIJK (SERVICE/BAR/MOP!ETC.) <br />SALES TAX CODE IS 7105 <br />NO. I NPE OF FI%TUR[ OR I7EM <br />� <br />A/C-A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREFLACE/STOVE <br />FIREPLnCE INSERT <br />GAS FIREPL4CE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I htEREtlY Ctftl IIPV IF1A7 1 FIliVt RtAU FND E.\AM1IINED THIS APPUGAIIUN AND KNUW THE S%��•1E TU tlE iNUt AND CORRECT. ALL <br />PROVISIONS OF LAWS FND ORIDINAC[S GOVERNING THIS TYPE OF �1'ORK WILI BE C019PUED VJITH V.'HETMER SPECIFIED HEREIN OR <br />1J0T. TKE GRANTIIJG OF A PER1.11T �CES NOT FRESUtdE TO GNE AUTHORITY TO VIOLATC Gn CANCEL THE PROVISION OF ANY GTHER <br />ST�TE OR LOC�L Ul�:' REGULl.71NG COPISTRUCTION OR iHE PERFORfdANCE OF COPbTRUCT10P�. TFU1T I AIA AUTHORIZFD B� THE <br />O'�1'NER OF THIS FRCPEftTY TO PERFOR!d THE WORK FOR �VHICH APPLICATION IS R1HOE AND I COM1!PLY WITH TME STATE <br />C;CIlI R CTURS LF 2/ RCW AND 2962U <br />��,�. �e ,��„ G., ,� L�/7�o � <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />