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�cRMIT APPLICATIuN � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3�Q0 CEDAP. STREET, EVERETT,WA 98201 <br /> JZS•�57-8810— FAX 425-257•8857 <br /> SITE ADDRESS PARCEL TAX I.D.M PER T M <br /> '� 1 � 1 - l � �l <br /> --+- - <br /> _«5� <br /> lOTNO. � OCN TRACT <br /> --Ch�'NE. ADDRESS P PHONE <br /> ��'� �i7 <br /> /('�fi�� / � /�!� i{ <br /> TLNANT NAME CONTACT FOR PERMIT PNONE <br /> '��'.� c f�0 h x�: <br /> CONTRAGTOR ,r ADDRESS r� 21P CONTR.LICENSE� <br /> PNONE� � F�...� �.^��. �-�c. . J�'� IC�� J C---- A�.�! � �J�iL� <br /> -��- -----/�� �3r�/�� <br /> PROPOSEO USE OF 8U0.01N6 L��ding M9thenical AOOitlon MEAT SOURCE <br /> Jr7 PERMIT K{-( Combinatan R{.� Plumbmg WORK AlteraWn Elactnc <br /> ,� ,,-! I��•�•, `CC(�`��I TYPE j..�j Demohtion V Sgn TYPE � Naw � cas <br /> � L.J Spnnkler RepavlMamL OMer <br /> COHTaJLT PPJCE OF WORK `��— CI7Y OF EVERETT LOCAL SALES TAX CODE IS]10S <br /> i <br /> WORK OESCRIPi104 l � <br /> C� <br /> PLUMBING MECHANICAL <br /> `�O I TYPE OF F1XiURE OR fiEM NO. TYPE OF FlXTURE OR ITEM <br /> WATER CLOSET�i OILE i) A!C-A/FIANDLING UNITS <br /> g/,TNTUB FOF'CED AIR SYSTEMS <br /> — LAVATORY(WASH 6ASIN) HEAT PUMP <br /> _I SHOYJER UNIT HEATERS <br /> I(JTCMEN SINK 3 DISPOSAL = CLOTHES DRYER <br /> O�SHWASHER RANGE HOOD <br /> LAUNDRY 1RAY WATER HEATER <br /> CIOTHES WA5HER fdETAL FIREF�ACEISTOVE <br /> URINAI FIREP�..ACE INSERT <br /> pRINKiNG FOUNTAIN GAS F�REPLACE <br /> FLOOR DRAIN GAS RANGE <br /> 9ACKFLOYJ PREVEN?£R GAS PIP�NG <br /> SINK(SERVICE/BAR/MOPIE7C.) EXHAUST FAN <br /> OTHER OTHER <br /> � EpEBv CERRiFV tMAT i HAVE REPD ht:D EVAMrt:ED tHiS Ai'PUCATION kN0 HNOW TMF.SAME TO BE TRUE AND CORRECT. ALL <br /> � -.:i5'C!+"r OF UYVS AND O�IDMPCES GOVERNING TMIS TVPE OF WORK WILL�E COMPLIED WITN WME7HER SPEUFIED HEREIN OR <br /> . ,- '��E ';�+PNii4G Of A PERMiT�70E5��OT PRESUMc 70 GiVE AUTNORITV TO VIOLATE OR CANCEL TNE PROVi510N OP ANV OTHER <br /> ' � �+,+ ,�"'!:FL UW REGUUTiNG CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I Atd AUTHORIZED UV THE <br /> :�'��•!��'.° 'w'�5 PROPERTY TO PERFORM THE WORK FOi2 WMICH APPL�CATION IS MADE AND I COMPLY WITH THE STATE <br /> �:�.•1'4�'�T;�SUW1 Y7RC G�9�.200WAC. <br /> `� , y- - D <br /> .�_ <br /> ! ;�e r/ o Agent ate <br /> ', D BIT 8 CREDIT CARDS ARE NOT A�CEPTED /2 <br />