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P�RMIT APPLICATIL�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8810 FAX 425-257-8857 <br /> c�v�� a�a o3� 0� �u� 3a5 -ooq <br /> SITE AD RE S � PARCEL TAX I.D.N PERMiT x <br /> �o ny ' <br /> LEGA LOT N0. BLOCK TRACT C /�.,,}p'a� O 2��Q h5� <br /> DESC. J IN � _ � <br /> OWNE ADDR S ZIP PHONE <br /> �io,a�`k Q�, c�,st, 3�aa e��r�u�. NE ��+ q�ao5 �{�-391-�3f� <br /> TENANT NAME CONTACT FOR PERMR PHONE <br /> I-4o,n�k C',�os, ConS+. I �� HQ�.ck W25- Z�O-24Z�1 <br /> CONTRA TON ADORE S LP CONTR.LICENSE N <br /> H��-�c 6�s, c�s� , 3��a. 6'l��ti� � F��kt- q��s Haa�kB�zol2Dz <br /> PMONE <br /> �1�a- 3�I1-'7 sc�o <br /> PROPOSED USE OF BUILDING pERM1T � Sp inkleetion U Plumb nga1 WORK � Rl�jpe1o�01n1 ItEAT SE�R�E <br /> N Fy., S F � TYPE H Demoiilion U Sign TYPE New Des <br /> �� Olher <br /> CONTRACT PRICE OF WORK �Q� O OO � �i/ ; ,�� CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> WOHK DESCRIPTION <br /> NP,,� s r- � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FJ(TURE OR REM N0. TYPE OF Fl%TURE OR REM <br /> I WATERCLOSET / A/C-A/HANDLINGUNITS <br /> BATHTUB �// = FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) ���� _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> � KITCHEN SINK&DISPOSAL T CLOTHES DRYER <br /> � DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATEti <br /> � CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREV�NTER GAS PIPING <br /> SINK(S[RVICE/BAR/MOP/ETC.) EXHAUST FAN I j l/ <br /> OTHER _ _ OTHER _ <br /> I — — <br /> � <br /> I HEREBV CEFITIFV THAT I NAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> '� PROVISIONS OF LAWS AND OFIDINACES GOVERNING THIS iVPE OF WORN WILL BE COMPLIED WITH WHEfHER SPECIFIED MEREIN OR <br /> '� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> � STATE OR LOCAL LAW REGUL4TING CONSTFUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOFIZED BV THE <br /> �. OWNER OF THIS PROPERTY TO PEFFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> i C TRACTO LAW 182 CW AND ,. 200 WAC. <br /> I I <br /> Sig ature UwnevContract uthonze enl Date �/Z <br /> � DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />