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_ �------- — <br /> . � P�R�1111T APPLICATION <br /> CITY �iF E\�EF2ETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> / O SJ.S� E v c�e /cc.✓ �v�1 Z g �� 7.� `� 0 2 OZ �o O S�µ O �-00`' _ <br /> LEGA LOTNO. BLOC � TRACT <br /> DESC. I <br /> OWNER ADDRESS ZIP PHONE <br /> � �R i n/ F�9 u �.v N o ._rz �/LS- 7�5�- .S-o i � <br /> TENANT NAME CONTACT FOR PERMIT PHOiVC <br /> AC✓ A�N� GA'N�S S��VL �COJ.r1� YLS 7�G' C C ?S� <br /> CONTRACTOR ADDRESS ZIP CONTR.I.ICENSE# <br /> J3crr� �/c.,.v cc 75cou f19.../.s -�- � I� ,� <br /> � ,.�.,�.�o y�� �., <br /> � "y o <br /> PHONE yzS 7� �� r� $3S 4 ����K� ' Z 3 <br /> PROPOSED USE OF BUILDING I� BUilding MechaniCal AddiUon HEAT SOURCE <br /> FERMIT �_� Combinalion R�.-( P�lurtlbing WORK Alle2lion � ElecMc ! <br /> G �� I�.� TYPE �j Demolition -4�'Si9n TYPE ew Gas I <br /> L) Sprinkier RepaidMaint. Other , <br /> CONTRACT PRICE OF 1'%�:.�K ,'�j ,s g�!� S � CITY OF GVERET7 LOCAL SALES TAX CODE IS 3105 I <br /> WORKDESCRIPTION �•Ns�'CC CI) �oLe S �yN <br /> SC-�/� o�-.�-� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSEI'(TOILET) _ A'C—AIHP.NDLING UNITS <br /> BATHTUB _ FO.^.^FD AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNITHEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br />� DISHWASHER _ RANGE FI00� <br /> LAUNDRYTRAY _ WATERHEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE I <br /> URINAL _ FIREPLACE IhS�RT <br /> DRINKING FOUNTAIN _ GAS FIFEPLACE <br /> FLOOR DRAIN _ GAS RANCE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> S�NK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER _ OTHER <br /> I I <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMIMED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL I <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERN!NG THIS T'PE 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 I <br /> STATE OR LOCAL LAW REGUV�.TING CONSTRUCTIOt�OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROf��RTY TO PERF HE OR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ' CONTRACTORS LAW ��°27 CW 2 A . - I <br /> ( 'O <br /> I� Signature wneri ontractor/Authonzed Agent �Dat� ��L II <br /> I DEBlT & CREDIT CARDS ARE NOT ACCEPTED <br />