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SITE ADDRE55 <br />�c'W ;-''a -�1 <br />LOT NO <br />F� cRMIT APf'LICATI�3�! <br />CI i Y OF EVERETT PERMIT SERVICES <br />3200 CGDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />�l IJ I � _� <br />�1�.� l .� <br />� !' 0 OCN <br />TRACT <br />PARCEL TAX I.D. # <br />����-�5 <br />. ,�-_ -� �� � <br />PERM1n7 a <br />.:o« �',� ___ <br />CI�S�.ri- I�c3'i) <br />� I <br />-CttiNER ADORESS t ZIP PHONE <br />�-tJ_a��2 �.�i:.,..,�,�...���L4.0 l�lu �3--3'i ��v.54 l�.,iiisS�q�5c:1J. ��?� �� '� <br />� 7 t ) <br />'['.AN7 NAA1E i CONTACT FOR PERMIT PHONE <br />— I �.�a L,e�>:>1� �1�,� •��3- � � � `� <br />CONTRACTOR <br />�-1._1,t�2 C(l�.ti��i��Sc'_'3 L.L('_. <br />ar+�NE �y1�-'1'-13-1i14� <br />�+HOPOSED USE OF BUILDING � <br />�, � �A �I �- ��-c.-�lA, � ��EIT <br />\� C: i � cic t=\\ �F'" � � <br />:O��TRAC f PRICE CF WORK <br />�tiOHN DESCRtPT10Y <br />40 <br />l �; � �. �i � � <br />ADDRESS ZIP CONTR. LICENSE N <br />��033. - 35�(aveSE <br />3��t1.��� 4�0��, f}t�PZRE���,,�-� <br />wld�ng j� Me[hdniCai I r"� ACmbcn I MEAf SOURCf. <br />Combination j�-{(� Plumbing IwORK Anereuon �� �� <<_•�. <br />Dertlolifi0n LJ Sign TYPE ew �;as <br />Spnnkler � �eoa�nMa�m L' :,. . <br />I CITV 0� EVGRETT LOCAL SALES TAX CODE 15 7t05 <br />__.._—__ -.___ � _._-- <br />�-' C..L: �� �1 y: c �-} �. ���1 . � y ��e'.� i c.� ��\:f' <br />, J <br />I:i�9Pi1�IP[�' <br />TVPE OF FIXTURE OR ITEM <br />YdATER CLJSET �TGiL[T) <br />Fii.7HTUB <br />�AVATORV (WASH BASIN) <br />SHO�NER <br />KITCHEN S'�NK 5 DISPOSAL <br />�dSN',1'ASr,EP. <br />�_AUNCRYTRAV <br />CLCTr+ES'NAuHER <br />,;RiNAL <br />:;RINKWG FOUNTAIN <br />F'LOCR DRi.�N <br />�aC!cFLO;ti PRF.vENTER <br />`��NK ;SER�: iCE 8AR G",OP ETC � <br />:'HER <br />NU. I TYPE OF FIXTURE OR ITEM <br />AiC - ��NANDLING UNITS <br />�_ FORCED AIR SVSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />� CLOTHESDRYER <br />RANGEMOOC <br />_L WATER HEATeR <br />METAL FIREPL.4CE�57�iVF <br />FIREPLACE INSERT <br />� GAS FIREPIACE <br />� GASRANGE <br />� GAS PiPMG <br />�_ E�HAUST FAN <br />1 O?HER i�1,c �� <br />--- �E�.T��F� '^� i'� �AVE R[AO AKD E\:.�diNF.'J THIS APPLiCRT10N AND KNO`�1"ME SAME TO BE TRU"e ��'�;: � �" - <br />_., � _ - <br />�. :'�.S G� �.i.1kS %.IvC ORiD'.NACES GC`JERN�NG TriIS TVPE OF WORK LNILL BE COMPL�ED 1M1'I'H VIh�ETM"cn �P=�:' ^ c': •�:-�•- •_ <br />- "^c i,R:.^.T�r�G OF 4 PERMIT pOES NOT PRESUME TO GIVE AUTHORITV TO VIOLc i E OR CANCEL ?Hc PRO`JiS�P. ;=�'. ��_ -. <br />-.;R ' OCA� �:tV qE�3UL4T�NG CONSTRUCTION OR TME PERFORfdANCE C� CCNSTRUC'ICN TMA? I Ald FUTnC�i :@_ :i . <br />... �G'-i5 oFnpcg*.- -� a_RFORAI'nE Vti'ORK FOR WH�CM APPLICATION �5 r„��CE 4pG �, C0:'P�_Y� ;'Ji*r^'�E 5'-'_ <br />.� C`OFS �..., __' 4�.:. ;.M1C 29c �QD �A'AC <br />' • �. � —___' J l 1 � ��—' <br />' �c �� .. .. :.�'h� �. .:2(B <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />yv <br />