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�, � <br /> . t � <br /> �_._ -- ------ —1 <br /> , <br /> i PERMIT APPLICATlON -�����'��,2� � <br /> ' CITY Of EVERETT P�ERMIT SERVICES CJLP� <br /> 3200 CE�AR STRE�l', EVERETT, WA 98201 � <br /> 425-2 -8810- FAX 425-257-8857 , � <br /> ��7/��/�.''�,�,���� <br /> SITE ApOREFw._ U � PARCEL TAX I.D.i RMIT N �Q��I,�.�j <br /> � >t?��SZa6 j.5`S.1ZrL''t F f '"' C�19C�0 <br /> �:e�.cEFi. Wn 40z.a�- »y )O C� <br /> ! L°G LOTNO. BLOCK TRACT <br /> �' D«C�I I � Z�Q� � �EVfxL-f N��Vi D��llStc�-1 �D. y <br /> I ONrt�ER A�DRESS ZIP PHONE ' <br /> �����, No�.. 5�30 :,,�,��k14y� EJ�err �. 9�3• yzs•3°I'i- 6 <br /> Ti-.NAH7 NAlAE COHTACT FOR PERMIT PNONE <br /> �,....L, ��� T,�m t"� � �u� - �YKcn�w aeu+rre�,s yzs-zs,-3i`) <br /> pNTRACTOR ADDRESS Z1P CONTRUCENSEi <br /> Pu�-,¢.rWs+-�' C-o�r¢�,.�x�s �o. P�oX 3S'�' aRu�u.�{�1n 98zz3 I�aerw.c !8�k4 <br /> PHONE <br /> PROPOSED USE OF 6UILDING '6Z� Bullding Mechanical � Additlan I HEAT SOURCE <br /> ��„y�/,q�U GusS�,cor� pERYIT F � Combinatlan R Plumhing IWORK Alteration � Ebctric <br /> I TYPE �._( Demdi�on D Sign TYPE New Gas <br /> U Sprinkler Repa'vnAainl other <br /> CpNiRACi PR10E OF WORK k � Z�C7 -�p�.� CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> M:ORKOESGPoFTION er 1Z Flo�w^l�'i <br /> r j�t�."S1R�'F+r"�t�`(_ HUt-T-wf� C��RE'� Grxtit�-f��^�, <br /> I ���yT�� e-�e.'[L�'C 3�o SF oF G�FFt�E AnL'� GV+-�'1 '7f'�. <br /> uFlt'f�+ 4�-Srj �'`"'�' <br /> PLUMBING MECHANICAL <br /> INO. TYPE OF FlXTURE OR REY NO. TYPE OF FIXTURE OR ITEM <br /> WqTER CLOSET A/C-NHANDLI�:G UNRS <br /> ah��B FORCED AIR SYSTEMS <br /> LAVATORY(YIASH BASIN) _ HEAT PUMP <br /> SHOVYER _ UNIT HEATERS <br /> KITCFiEN SINK S DIS?OSAL = CLOTHES DRYER <br /> DIS'rtWF ER _ RAN�E HOOD <br /> LAUNOP.Y Y _ WAiE12'f{F1.TER <br /> CLOTHES W eR _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE�SERT <br /> DRINI9NG FOUNTfJ _ GAS FIREPLA F� <br /> FLOOR DRAIN GAS RAIJGE <br /> BAC!Cr'LOW PREVENTER _ GAS PIPING <br /> S1NK (ScRVICE/BfvZ/MOPlE7C. __ EXHP.UST FAN <br /> OTHER _ OTHER <br /> — � \. <br /> � I HF.F2EBY CERITIr^!THAT I HA�FiEAD AND DW�IINED l}'.IS hPPLICATIONlW D IQJOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> iP30VISIWS OF LhWS ldJD ORIOINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WfTFi WHETHER SPECIFIED HEREIN OR <br /> �I�T. THE GRAtlT1NG OF A PERldR DOES NOT PRESUME TO GIVE AUTHORRY TO VIOLhTE OR CANCEL THE PROVISION OF ANY OTHER <br /> � STh i E CR LO.^.:.L LhW REGULhTING CONSTr UCTION OR THE PERFOP,MANCE OF CONSTRUC'iION. THAT I AM AUTHOFiZED BY THE <br /> � CI.Td'cR OF TNIS PROPERTY TO P�RFORIA THE WORK PCR WHICH APPI�CATION IS MADE AND I COMPLY WITH THE STATE <br /> I C�NTfiACTORS LFV/78.27 RClI hND 259200 WhC. <br /> i � / � <br /> �y, v�o� <br /> �� Signature o rl ontrar.odhuL�onzeC hgent ate �'Z <br /> DEBIT 8 CREDIT CARDS ARE NaT ACCEPTED <br />