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�ERMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS a0� �5 f C�.S%�o ReI PARCEL TAX I.D.N P RMiT a <br /> s,,; � N oa s98�o �oo /o/ �o3os -Us <br /> LEGA LOT NO. � �•n BLOCK TRACT II <br /> DESC. I� Z� J , 31 r3 'To5/4nac H4�� �✓� Gar�R..�1 Tr.�� <br /> OWNER�'vQ� 2'NvP,S{,M+H�� ln� �DRESS 21P PHONE �`,u�'33/3 <br /> pv. �3oX /93zo <br /> c�lb/q G.s,�o Sso<�� E,st seql��<, �✓A 99ro9-i32o <br /> TENANT NAME ONTACJ FOR PERMIT PHONE <br /> �a. T��,�Q p� T�y�;l4 I �►Y�S�eG ,uo„� �s y�s- a�s— 9�97 <br /> CONTRACTOR ADDRE33 ZIP CONTR.LICENSE N <br /> (�ahcQ�/ nce�'llY C��s�"��c{Krn (? a, /aox 4�N S�*t�i�vs'� 98aL RqN4YLRo/ool <br /> PHONE�, eG _ 7q 9�[��00 <br /> PROPOSED USE OF BUILDING Building � Mechanical Add�Oon HEAT SOURCE <br /> PERMIT � Combinallon Plumbing WORK R Alleratlon r EtecUic <br /> �1cL ' TYPE Demolition Slgn TYPE R New D cag <br /> �C �`�' / Sprinkler v Repalr/Malnl. D oma� <br /> CONTRACT PRICE OF WORK .�� p pd CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> WORKDESCRIPTION Re „�o�,e� eX�$ iny /'t � ,f�J4cQ e 4d 4 o p/e�J�r is•yt <br /> aYe4. Pi,.m b,n� <«ld<<0 w��� � 3-ca»r�o<r�n,� S�:,K� yr.caso� '�mp� �/o.v S�n•� <br /> rno/�.s,.,,t' FYK,- �a�'., �•.c/ �4 hJwas/, s�'nK• 9 F'{�� aF' eXrs�� wf�l rvnw�oA <br /> �1e..� ��ny/ f�Y.� F/�.,� ,r-.,c0 nc.� c�� /��y, d.�s,'�w ( improvQ,.�o.t� �nr�;� no. 801�� -oiy <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(VJASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> K�TCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> D�SHWASHER RANGE HOOD <br /> LAUNDRY TRAY _ WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBV CERITIFV THAT I HAVE READ AND EW+MIN[D THIS APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITN THE STATE <br /> CONTR�AC ORS LAW 18.27 RCW AND 296 0 WAC. <br /> �f�C,.n� � � S- 3o -u� <br /> STgnatur f Ownei C n ractor tho zed Agent Dale �I� <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />