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I <br /> ! P'ERMIT APPLICATION � <br /> �I CITY OF EVERETT PERMIT SERVICES <br /> � II <br /> i 3200 CEDAR STREET, EVERFTT, WA 98201 ' � <br /> �! 425-257-8810- FAX 425-257-8857 � I <br /> �� - 9 -6 � <br /> �I SITE ADDRESS PARCEL TAX I.D.N PERMiT• ' <br /> �Doq oA�Y RvRD ca-��f�F3t00002?0o Cy.o3 - Z� <br /> LFGA1 LOTNO. BLOCN iRACT <br /> r,E sc _ Z7 — F!4� fzu l�u/ t!E t!�I-�'f S <br /> ONMER ADDRE99 ZIP PNONE <br /> I iLIkRGA�P-ET E. C�k-4Ef�EY 52o-�t2��5u1-�3� �/Ep�'iT48�F �-�✓3�D3�o <br /> 'i TENANTNAME CONTACTFORPERMIT PHONE <br /> � 'B �w u-tiEN�Y .lot�cN Grt��Y 3�0-�-535�+ ' <br /> � CONTRACTOR ADDRESS ZIP CONTR.LICEN9E/ I <br /> � ...1Ct-t�l UtEµEY 15oc} �KoAA Si. N10�1�'f 1l6¢}.�l �'01�7�{ rlor�(ow�.�ER) � <br /> i� PHONE <br /> �� 3u�-�tti-t-535�} <br /> PROPOSED USE OF BUILDINO � Bwlding Mechanical AaEmon HEAi SOURCE � <br /> PERMIT Combmation Plumbin WORN Atlorehon ElaCnc <br /> /� 7 � � <br /> DW���NI� TYPE Demoldion Sgn TYPE Naw Ges <br /> Sprinkler Repnirn.�ami Other <br /> � CONTRAb f PRICE OF WORN I Q �u � �CITY OF EVERETT LOCAL SALES TA)I CODE 19 7f06 <br /> i — � — <br /> WORK�EBCRIP710N qDp � �TNR�,�1. �y �p�D F� WITniN-rtt� <br /> �`x 7��N� Vi/� ����iNv�✓V{�• <br /> PLUMBING MECHANICAL <br /> NO. TYPE Of FIXTURE OR ITEM N0. TVPE OF FIXTURE OR I1EM <br /> ( WATER CLOSET A/C-A/HANOLING UNITS <br /> � OATHTUB _ FORCEDAIRSYSTEMS <br /> 1_ LAVATORY IWASH BASINI HEAT PUMP <br /> �_ SHOWf-.R = UNIT HFATERS <br /> KITCHEN SINK 8 �ISPOSAL CIOTHES DRVER <br /> DISHWASHfR _ RANGEHOOD <br /> IAUNORY TRAV _ WATER HEATER <br /> CLOTHES WASHCR __ METAL FlREPiACE/STOVE <br /> URINAL _ FlREPLACEINSGRT <br /> DRINKING FOUNIAIN _ GAS FlREPLACE I <br /> FLOOR DRAIN _ GAS RANGF <br /> BACK�LOW PREV[NTER GAS PIPING <br /> SINK ISERVICE/BARIMOPIFTC � = E%HAUST FAN I <br /> OTHER_._ _ OTHER _ • <br /> I HFREfiY CFRITtfv iMAT I MAV[READ AND FXAMWED TNIS APPLICATION AND KNOW TNE SAME TO BE 1RUF AND CORRECT ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE Or WORN WII.L BF COMPIIED NATH WHE7HEq SPFCIFlED HEREIN OR <br /> � NOT THE GRANTING Of A PCRMIT DOES NOT PRFSUME TO GN[AUTHORIiY TO VIOLAIE OR CANCEL THE PROVISION OF ANY OTHER <br /> I SIATf.ORLCKAIIAWFi1.GULATINGGONSTRUCiIONORTHfPGRFORMANCfOPCONSTRUCTION THAiIAMAUTHORI2EDBVTHE <br /> I OWN[R O� T��IS PROPI�RIY 10 PfRfORM THE N4)RK FOR WFllf.hl APP!N:ATION IS MADF. AND I COMPIY IMiH THE STATE <br /> i CONTRA TOfi51�W 1fl 77 RCW AND 29f\.700 WAC <br /> 11T�� _��r�y�--. <br /> alure o:Owne ontradodAul orhl�Jl�gent���� Da�e I <br /> iDEDIT d CREDIT CARDS AHE NOT ACCEPTED / Z <br />