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SITE ADDRES3 <br />LOT NO. <br />DESC. <br />P�RMIT APPLICAT <br />CITY OF EVERETT PERMIT SERVICES <br />32�0 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />� p -Z <br />TRACT <br />PARCEL TAl( I.D. # <br />PERMIT N <br />1� O�{ G� <br />A6-c1JT ' <br />CDkSrQ.F?�.c[iR-Ct lt'hJ1�tJ L��o �►'t"7'w�l.�f c'+a�•.tTr 't('1J1 N�l ?39-3638 <br />7ENANT NAME CONTACT FOR PERMIT PHONE <br />MfkT0.10S1�A r'krwvr�ra I J�w Rw�r�a �-Iis 346-5"3�7 <br />CONTRACTOR � ADDRESS ZIP CONTR. LICENSE N <br />J'� i°t�L�s�a C iT�Wcr��a 3�Zf Co��y ,9-vt +! �r GY� 1 J�1�u,CIWtiK4 <br />PHONE u",L� �44 � 3 �,� <br />r a,�c z.u� c <br />PROPOSED USE OF BUILDING <br />j� Building Mechenical <br />PERMIT p Combinatian � PIUml11�g <br />TYPE DemoliL'on Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK b� J.._. <br />WORK OESCRIPTION � <br />[ i n� e,-w�.f- P4 �i a— wR «S <br />/�—�C QL✓-✓�•ri �N4— i (h7ai� ..t! <br />NO. I TYPE OF FIxTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />L/�VATORY (WASH BASIN) <br />SHOW ER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFIOW PREVENTEP. <br />SINK (SERVICE/BAR/MUPIETC.) <br />OTHER <br />,ra o <br />Tu+ u <br />Addltlon HEATSOURCE <br />Alteratlon Eledrlc <br />New � Gas <br />RepalrlMalM. � Other <br />CITY OF EVERETT LOCAL SAL£S TA7( CODE 19 ]103 <br />N m G'�-'^ i '� �++eo 0 J u�2 <br />S 1�J �cI ��i Y O✓' I�b l�) <br />NO. � TYPE OF FI%TURE OR ITEM <br />A/C—AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CL��THES DRYER <br />RANGEH000 <br />WATER HEATER <br />METAL FIREPLACFJSTOVE <br />FIREPLACE INSERT <br />GAS FIREPLl�CE <br />GAS ftANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />1 HEREBV CERITIFV THAT I MAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF L4WS AN� ORIOINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME'O GIVE AUTHORITV TO VIqIATE OR CANCEI. THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TME <br />OWNER OF THIS PROPERTY TO PERFORM i HE WORK FOR WHICH APPIICATION IS MADE AN� I COMPLY WITH THE STATE <br />CONTRACTORS LAW 7�^�7'RCW?�ND:�6.�D0.WAC. <br />�`� <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTEO <br />