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SITE ADDRE33;� <br />�ZO�g 1>ur�f <br />LEGA LO? NO. <br />DESC. <br />OWNER � <br />k s -{�-n c.� <br />TENANTNAME <br />CONTR.>CTOR � _ ,,,, <br />PHONE ��� <br />�ERMIT APPLICATfUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />BLOCK <br />� a �,..,.._. <br />PARCEL TAX I.D. A <br />��OS �—�c <br />TRACT <br />C)3 U 210v <br />PERMIT p <br />CONTACTFORPERM PMONE <br />�j ,.x� �j : � C�' � i-L-, y �s 2 3 �r s- � S� �- <br />�� ��DRESS `� �� ���! �3 r( O <br />r - r� <br />PROPOSED USE OF BUILDIN6 <br />S�� <br />Building <br />PERMIT R Cambinalion <br />TYPE D Demolltion <br />U Spdnkler <br />CONTRACT PRICE OF WORK s� ?f- ��--� <br />Plumbing <br />Sign <br />ZI GOfiTR.LII:CIYOt11 � <br />9�'z�z C�M��r�t, <br />q € �.�v <br />�� <br />terauon <br />New <br />RepalrlMalnl. <br />HEATSOURCE <br />ctrlc <br />Gas <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX COOE IS J708 <br />WORK DESCRIPT19N �/� Q `� f � <br />�L 5(�� /�Cp�,-� .�-�r.t 7<<�' �-�-Y„-`�.'G�` r� h-�^-^-'"�{ <br />� l�,J � cti �-t�-i c�ccQ UQ .l�' a-� <br />N0. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />0TI1ER <br />NO. I TYPE OF FOCTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEATPUMP <br />UNIlHEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACEINSERT <br />GAS FlREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBV CERITIFV TMAT I HAVE READ ANJ EXAMINED THIS APPLICATION AND KNOW THE SAMC TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERN�;�G THIS TYPE OF WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT ^RFSUAIE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOC/+. LQW REGULATING (:ONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY TME <br />OWNER OF THI PROPERTY jp PERFORM TNE WORK FOR WHICH APpLICATION IS MAOE AND I COMPLY WITH THE STATE <br />CONTRACSO LA�y 78.27 RQVV A D 296.2��IAC. / <br />\ � , � A ; . � �/,.-�-� 10�3�. e � <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />