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SITE ADDRESS <br />7�5 is (=�-e+' ►-zen <br />LEGAL LOT NO. <br />DESC. <br />� PERMIT A�'PLICA�� ION <br />CITY OF EVERETl' PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX I.D. # <br />a�so5o '7 o0 3 G� roa <br />BLOCK TRACT Scc- V% TwP 24 I <br />A1c� 7-85 Rtc•,�( ¢aoKl eF Q,s. <br />�i�,--�-lJ. �aSe%/��' ��v <br />TFNAN AME � <br />�,Ve 1�"5 Fn rr� o�i � c� h c ��( <br />e� <br />PHONE aG4 �7q�'1 ` Q/�0 <br />! <br />PROPOSED USE OF BUILDI G, <br />O��'�G£ d- i�4�, � <br />'U�0 <br />Py'.�� A� nb Ssi z31� ot� I <br />p. /�uX /ri32o Sz.qtyl.r ��0/oS-�32u...._�aC,-?G5-33j� <br />CONTACT FOP PERMIT <br />✓Gt p Wea2Y I <br />�fQ+� M4.s141 �-✓ <br />Cs`N3�Y'�('�npAD�RESS /J��.i.k'X y�� ✓�5� <br />Building Mechanical <br />PERMIT B Combinalion � Plumbinc� <br />TYPE D Demolilion Sign <br />u Sprinkler <br />CONTRACT PRICE OF WORK '�F95' OQb � <br />WORKDESCRIPTION R�d{��lS-e o �X�$ ��� <br />,�Y 7�SsF. �re rea�fro�•nr t �.�,�����,. <br />/i�G�� QF�/�reS� � f0 � o� I"10 �¢ 5'fY••:�+„iE��j� � <br />�ja5 +-KVAG .�+•h�t�ti SA�[eeS� <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <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 />PHONE <br />2�•G� Z�S - 33�3 <br />� �� z�&�ZcoN�ANoYL�G l�a � <br />AddiUon I HEAT SOURCE <br />WORK R AlleraAon (� Eleciric <br />TYPE D New D Gas <br />D Repair/Mainl. � Olher <br />CITY OF EVERETT LOCAL SALES TAX CGDE IS 3105 <br />:i .S�G25 1ACVe4<itip W�1�5 �U <br />F�w+s, �o ltJe/�s l�-rye 4ve��. <br />F�n��re.. S�ptr2.t<< E/lc,�i�d.l <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 />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY TI1AT I HAVE READ AND EXAPAINED THIS APPLICA i ION AND Y.NOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY 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 PERFORM THE WORK FOR WHICH APPLICATION IS h1ADE AND I COMPLY WITH THE STATE <br />CONTRACT,ORS LAW 18.27 Rp�N AND 29620� WAC. <br />y-z5-a� <br />: of w edContraclor/ onzed Agent Date <br />�o-s-� /i'i2YL4yF/� ��1i <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />