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�' <br />SITE ADDRESS <br />7Zo'7 ( <br />LEGA LOTNO. <br />TENANTNAME <br />CONTRACTOR <br />(�QOLW <br />PHONE ,/���\ <br />�"( J <br />PERMIT APPLICATIO <br />CITY OF EVERE'TT PEkMIT SERVICES <br />3200 CEDAR STREET, EVERETT, bVA 98201 <br />425-257-8810 — FAX 425-257-8557 <br />EJ <br />BLUCK <br />207 � <br />PARCEL TAX I.D. H <br />� 072�'OS —Z—o <br />TRACT <br />NAME <br />_d00� <br />PERMIT +� <br />J�30 /- <br />3y9-SoyY <br />AO�RESS ZIP CONTR. LICENSE N <br />i�1�N lh1L �TBoo 1�,2��ur_ (�Ufc�= �2� ti{UK+�jL'v �3�1.75 l97�0`LNIO�(�Ol� <br />'>Yg-s <br />PROPOSED USE OF BUILOING <br />C�.�1v��cikz <br />CONTRACT PflICE OF WOflKy�Z� <br />Building Mechanical <br />PEaMiT � Combination �Plumbing <br />TYPE Demolilion Sign <br />Sprinkler <br />�Addition <br />Alteralion <br />New <br />Repair/Mainl. <br />HEATSOURCE <br />Electric <br />Gas <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORKDESCRIPTION wNLr.�� �lC-�� �LLUM)/.1/}�R-7� <br />INyTA'�-L �2� CU5TDM6'Z 4 <br />�(.� l}�i. � �j/G-�`15 <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />� OTHER <br />NO. � TYPE OF FIXTURE OR ITEM <br />A!C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAI. FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREf'LACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIF'f THAT I HAVE READ AND EXAMINED THIS APPIICATION ANO KNOW TNE SAM17E TO BE TRUE AND CORRECT. ALL <br />PfiOVISIONS OF LAWS AND OHIDINACES GOVERNING THIS TYPE OF 1NOFK WiLL BE COAIPLIED WITH WHETHEfl SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PFRM1tIT OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAI LAW REGULATING CONSTfiUCTION OR THE PERFOFMANCE OF CONSTRUCTION. l"HAT t AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOF WHICH APPLICATION IS MADE AND I COh1PLY W�TH THE STATE <br />CONTR TORS LAW 1827 W A D 296200 WAC. <br />�J���� ��� � ; �/z� j� <br />Sign�rci of OwnedConlracl vAuthonzed Agent Dale �/a <br />