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FEB-24-20�4 09:30 FROM: .-'�: '_402578857 P.1 <br /> PERMIT APPLICATB�IN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SRE ADDRESS � PARCEL TAX I.D.# PE MIT� --- <br /> f✓— 111 D-LI�t,�ar�e �}U[-= Oo`flOz000l27Gc� � l'� C(c:> - c >`� <br /> IEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRE55 ZIP PNONE <br /> C�lev�h c.�-m�f �i � r �el�a-c.�ue �ve �i;� q,��3 5�z�zs-z c�� <br /> TENANTNAME CONTACTFORPERMR PHONE <br /> � C�.►�.cku �,�C� 2�� z�2 S� <br /> CO CT R �I rn i ADDRESS ZIP COHTR.LICENSE il <br /> t,e�����''�J`�� LCY,J <br /> PH�� 2.�a,`tfbtmcQ �4+�c � �f'�-/ ��KIE.�")l c,� <br /> PROPOSEDUSEOF9UILOING Building 2ch2nic�l � ('� Additlon HEATSOURCE <br /> � I pERMR R CombinaGon Plumbing WORK K Atteratlon Qa��c <br /> TYPE D Demolltlon Sign �E �j RepalrlMalnL ��wer <br /> U Sprinkler � <br /> CONTRACT PRIGE OF WORK ��i � CITY OF EVEfiE'fT LOCAL SALES T/UC CODE IS 3105 <br /> WORKOESCRIPTION ^^p 1 /'L^S � C <br /> (�oY� 1(J v�•' <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO.. TYPE�F FIXTURE OR ITEM <br /> WATERCLOSET(fOiLEn _ AIC-AlHANDLINGUNITS <br /> BATHTUB _ FORCED.4IRSYSTEMS <br /> LAVATORY(WASH BASIN) _ HF�T PUMP <br /> SHOWER _ UNITHEATERS <br /> KITCHEN SINK 6 DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY = WATER HEATER <br /> CLOTHESWASHER _ METALFIREPIACE/STOVE <br /> URINAL _ FIREPLACE INSERT . <br /> DRINKINGFOUNTAIN _ GASFIREPLACE <br /> FLOOR�RAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICEIBAWMOPIETC.) _ EXHAUST FAN <br /> OTHER _ OTHEFi_ <br /> 1 HEREBY GERITIFY THAT 1 HAVE READ AND EXAMINEO TMIS APPLICATION AND KNOW TH[SAME TO BE TRUE AND CORRECT. ALl <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GFiANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO'✓IOLA7E OR GANCEL TME PRGVISION OF ANY OTHER <br /> OW NER OF�HIS PROPEFiTY OTPERFORh1 THE WORK FOR WHICH APPLM CAT10N IS MADERAND I�OM1 PLY W ITH THE SOAITZEED BY THE <br /> CONTRA RS .27 RGW AND 29 00 WAC. �� <br /> Slgn re nedGo tractor/A rtzetl Agent Data <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />