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r <br /> ...-. � � � <br /> P'ERMIT APPLICAT�ON �pA c2�-�syl <br /> GITIf OF EVCRETT PERMIT SER.VICES �e�� pZ -,C��� � <br /> 3200 CEDAR STREET, FVFRE"fT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE AUDRESS PARCEL TAX I.D.# P RMiT# <br /> �107 �II�RI��� 4�+N db58tq8D0Az��i I -OZ/ <br /> LEGA LOTNO. BLUCK TRACT <br /> DESC. <br /> OWNER ADURESS ZIP PHONE <br /> FE4516fANl�LE1�jRlE c��1'EYY87T �o� Ever�n�u I�i.,y P.D� 1143 48?efe <br /> TENANTNAME CONTACTNAME PHONE <br /> A�dSt/�NC� (�i�oF A19EETT I G�'l1,hM1L� •�l�FI.NJlffl.�ktL 9�'S'.2S7 0868 <br /> CONTRACTOR A�DRESS LP CONTR.LICENSEM <br /> 6�V c�srt�vcniav7�e. lasrt t?�"f1vE. sE �oFte C � 9�8 ��qF�N¢ �0'fK3 <br /> rHUN�`5.33$.?ll� <br /> yT <br /> �PROPOSED USE OF BUILDING I pERM1T f-( Sp nkllealion � Pl9n b ng I ITMPEK � ReNafrlMal��. I HEA�O�Rric <br /> �P/O�J� 7YPE H Demolition <br /> Ll <br /> CONTRACT PRICE OF WORK /, ��GL i-/y� CIN OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br /> (/(�C/ <br /> WORK DESCRIPTION <br /> tuEw mn�oN aF A u,000 4� aw'idi►� �r +�sR�wcE l�� aF �ir�rr 7�r�e,F-r <br /> sr�op �w� a�Ea�mak u�boc l�r.c._. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR I7EM NO. TYPE OF FIXTURE OR REM <br /> WATER CLOSET A/C—A/HAND�ING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUhDRY TRAY WATER HEA.TER <br /> CLOTHES NIASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPIACE�NSERT <br /> DRINKING FOUNTAIN GAS FIRFPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> � SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER S?ECIFIED HEREIN 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 REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERrORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS IAW 18.27 RCW AND 296200 WAC. <br /> \ <br /> Signature of OwnedContracrodAuthonzed Agent Date 1/Z <br /> � .� <br /> � �l 'Z j5 <br />