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�. <br />PERMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS <br />•)_Zfl FiRLRMD P��;�E <br />LEGA LOTNO. BLOCK <br />PARCEL TAX I.D. A <br />oo5ao(o 00000.�{ <br />rnncT <br />e� L ✓/Eu1 <br />��3os-�� <br />P,g�Mrca <br />l n2dS- O ! � <br />.,..��n ----•---- <br />�r/DREW �31..OM81:R('j- 221�G�RLAn�D PtAcE&� 203 NZ5-353-91n/3 <br />TENANTNAME I CONTACTFORPERMIT PHONE <br />owNER N25- 353-9(c/ 3 <br />C�S�IX�TP�ANN/%Inl%�i OF H%FiW ADDRESS LP CONTR. LICENSE Y <br />faaao iscn� l6usEN�/GZH7 <br />PHONE (/� - 3%9 -%%�(� � 3t,o - 3$%�9Z$ <br />PROPOSED USE OF BUILDING <br />�+N6lE FANIW tb'1E <br />CONTRACT PRICE OF WORK � ��� <br />Building Mechanical <br />PERMR � Combinalion � Plumbing <br />TYPE DemolitiOn Sign <br />Sprinkler <br />Additlon <br />WORK Atteradon <br />7YPE New <br />RepaidMeint. <br />HEATSOURCE <br />�Eledric <br />Gas <br />OMer <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �705 <br />WORKDESCRIPTION AaA _�3395F TO l�KLU�E �. REDR�NS� I BR�� �RMIL`I RCnH4'AKGK. <br />RFXor�FiGuRE EwsfiN� �sPACE To N�E CA�NDK�� ADOYLBfF7}I .- uGr�anDe KrrcNFi�• MD <br />z CPtA CrH2�4Cr�. . �c7lo <br />NO, I TYPE OF FURURE OR IIEM <br />WATER CLOSEI" <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBAR/MOP/ETC.) <br />OTHER <br />NO. I TYPE OF FIXTURE OR REM <br />A/C - AIHANDLING 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 />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW 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 PiESUME TO GIVE AUTHORITY TO VIOIATE 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 PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />