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� <br />� <br />MIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CE�AR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS � � PARCEL TAX I.D. R <br />I�(OS SE EVE�F� MALI- V'�A�J ��"OS ��0o�(O �{5 d� <br />LEGA LOT NO. BLOCK TRACT <br />DESC. SA <br />OWNER ADDRESS <br />�'d tst�'�i lrA.l,L O1 L�C- 1344o Ve..�.k uxti 6 � vD .� Sw � I� 2 0 0 <br />PERMIT q <br />SO ZDCn -O <br />S1. e.�- h.s�.. O c.l� 5 Gf�i <br />�ti�4z3 <br />TENANTNAME CON7ACTNAME PHONE <br />�a.r7's Ti�X S4to P ��-t Qor�.f a� 8oc� -Hi7 -�w�1co ext io� <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE M <br />b w'� N c,�l's ��� s�c,.�. S7 sre,�,. 8 W 6{-l. Av� S. <br />PHONE DWIN�YSo7(oN�1 <br />Sn o- K�7 - �NK(- e,cF. lol �•�� � WA `1813N <br />PROPOSED USE OF BUILOING <br />_ R��'a�c. <br />Building Mechanicai <br />PERMIT R Combin2lion Plumbing <br />TYPE D Demalilion ign <br />D Sprinkier <br />CONTRACT PfiICE OF WORK � 5'L/ 5"j� � �� <br />Addition I HEAT SOURCE <br />Alleration R Electric <br />New �j Gas <br />Repair/Mainl. U Olher <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3705 <br />WORKDESCPIPTION Re�..,p�/Q, u�.¢, O�cL Sic�n. p��, Iy.STAI� ov�e y�e.u� �exa� 'F�C-t. �IH <br />oxc zkis�it�.� w�.0 caSiw�i ���_���k �.o'-o�� = SO s�{{' � horkl. e.�e,vc�iac-, �y.St�i�j , <br />Ov�� v�e.w Se.t cL.�..�+ne,l Iz-lies5 "G—orYs T�+'� SI.�P �� �'-o`� }C 7�-3h %�.1.755� <br />NO. � TYPE OF FIXTURE OR ITEM <br />� <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHqWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />@.4Ci<FLOW PFEVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C -A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES ORYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERIT�FY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVCRNING THIS TIPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PER�dIT DOES NOT PRESUh1E TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LiW fiEGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2E0 BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WOFK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 iiCW AN� 296.200 WAC. <br />/'� � . /��� _ <br />�o'1--i l7%�� <br />e <br />��Z <br />