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lllli-CJ-UC lit le;be PM tC ALIT PERMIT SERVICES FRX NO, 4F{ 157 8857 P. 02 <br />r- <br />PERMIT APPLICATION <br />4EYr CITY OF EVERETT PERMIT SERVICES <br />32..00 CEDAR STREET, EVERETT, WA 98201 <br />425.257.8810 — FAX 429-257-8887 <br />SITE ADDRESS �. PARCEL TAXI.D.0 PERa1rTY <br />�. ' �j.'_,r 1 Aae 1,K a _,-934-4p 9-�rr'o._ ov <br />LmiN LOT No. T SIOCK TRACT . <br />CESC <br />OWNER / 1— y <br />_K_( l`/ Jt.._t)f .. <br />NA_✓_.PrP �J%3U � 7 a� ��c3®/ 25�%'O�QJ <br />TENANTME ( CONTACT NAME PHONE <br />CtONT114C - ADORE9E p�/� k 21P CONTR. LICENSEM <br />PHONE '�.�%?� fAsT JIi r <br />-- -- �. _ _ r *9-2e. <br />PROPOSED USE OF nU1LDING <br />+ <br />CON i RAcT P <br />WORK DESCRIPTION <br />4 D <br />\O. ' 'TYPE OP FIXTURE OR frem <br />i <br />WAIL•li (:LOS2T <br />PAT HTU IJ <br />LAVATORY OVA& I OASIN) <br />EHOSV:R <br />1:I'ICI!'lzN SINI(S DiSF SAL <br />OISHWASI I(: <br />LAl1NOI;Y TRAY <br />CL01! ii7S WASHE <br />USINAL <br />DITINKING FOUid AIN <br />FLOOR DRA:N �... <br />BACKT•LU'W PrIFVFNTER <br />SINK (5I:RVICEfOAP�V0P/ETC.) <br />On <br />• Building Ntechnnlctl <br />Combinntion Pluumbing <br />=,tion <br />Alteration <br />WORKIN, <br />HEATSOURCEPERMIT <br />(7 Eledrk <br />TYPE DFT011tlon Sign <br />TYPE New <br />Na <br />Sprinkler <br />Repa�cmlaint. <br />[[7j <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />NO. I TYPE OF FIXTURE OR ITEM <br />-,y A/C— A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGrHOOD <br />WATER HEATER <br />METAL FIREPLAC OVE <br />FIRES <br />INSER <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I nH1'B?O ;E..:TIFY T! IA I I IAVe H'r.AO AND EXAMINED TI IS APPLICATION AIJD KNOW THE SAME TO SE TRUE AND CORRECT. ALL <br />'r'Ar JL'>IC' o C•`� I.A17$ AND c)n:oiN,\CES GOVERNING TI11.3 TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIRFO IIERFIN OR <br />-HE QirJJTiNG OF A PERMIT COSH NOT MIESULIC TO GIV�AUn-IORITY TO VIOLATE OR CANCEL THE PROVISION OF AN." OTHER <br />LOC'nl. Law ft1; r�Ui aT�NG CG'+^uTRUOTION OR THE PERFORMANCE OP CONSTRUOTION. THAT I AM AUTHORIZQO BY THE <br />_,to <br />I GF THIS P,'OPCRTY TO PERFOHa! i HE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY LVITH THE STATE <br />?SO- 177S <br />