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SITE <br />�J <br />/S ,�, <br />l0T NO. <br />ol.. <br />NAME <br />--�--- ----�--- <br />PERMIT APPLICA,TION <br />CI7Y OF EVEREYT PERMIT SERVICES <br />3200 CEL�RR STREET, EVEAETT, WA 98201 <br />�I25-257-d810 - FAX 425-257-8857 <br />���p)�.�7RACTOF{ ' � <br />`PL_(J�¢.. `�/V-��-y���_r_�_ <br />PHOME <br />31ac9.[os;�.-759/ <br />PROPl1SED USE UF BUILDING <br />� �^"��- �° <br />CONTRACT PRICE OF WORK <br />� C� TpQG <br />PARCEL TAX I.D. M <br />�oi.�3 O�d /O � Co <br />CONTAC7 NA <br />�—�� <br />ADDRESS <br />Building Mechenical <br />PEF,MIT Combinaliou � Plumb(ng <br />TYPE Demolitian Sign <br />Sprinklor <br />WORKOESCRIPTION , . <br />� .s.�...�. � /��—. <br />7��t �-G� �c.—K.. <br />(0 5 e,. a ir, d � c n L+�- <br />N0. I TYPE OF fIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWEP. <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TFAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVErITER <br />SINK (SERVICE/BAFUMOP/ETC.) <br />OTHER _ <br />ti i e i v+. <br />TYPE <br />LP <br />'cJ 1/ � c3o3 <br />L P MIT M <br />�C�/l / - OO� <br />/,2n2-/S-� / <br />i/ <br />PHONE <br />�-� v r� $� • 75g / <br />CONTR. LICENSE M <br />^��=��,�l�TX o9�TZ <br />�(� Additlon I HEATSOURCE <br />Alleiation j7 Eleclrk <br />New I .R� Oes <br />Repeir/Mulnt. Ll O�her <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />NO. I TYPE OF Fl%TURE OR REM <br />A/C -A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEATPUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANG[ <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERIiII-Y THAT I HAVE READ ANU EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. All. <br />PFOVISIONS OF L�: WS AND ORIDINACES GOVERNING THIS TYPE OF WOPK WILL BE COMPLIED WITH WtiETHER SPECIFIED IIEREIN OR <br />NOT. THE GR�I�TING OF A PERMI' DO[S NOT PRESUME TO GIVE AUTIIORITY TO VIOLATE OR CANCEL THE PROVISION PF ANY OTHER <br />STATE OR LOCAL I.AW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERIY 1�0 PERFORM ThiE WORK fOR WHICH APPLICATION IS MADE AND I COM17PLV WITH THE STATE <br />CONT6IACTORS LAW 1827 RCW AND 298200 WAC. <br />