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� <br />� <br />SIT[ ADDRESS <br />�5 �S � . <br />LEGA LOT NO. <br />�\ �E �t E � � <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEUAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX I.D. A <br />�c-�1- <br />BLOCK TRACT <br />ADDRESS <br />_ 5.� �5 � , ps;�r� �v�-� <br />PERMIT N � <br />h1��j�- Oa5 <br />HONE <br />4Z�_3S5-q5o8 <br />TENANTNAME I CONTACTNAME PNONE <br />CONTRACTOR ��, �C� ADDRESSZ���Q ���J � LP CONTR.UCENSEII <br />PHONE ��^ y3/ — r �A � <br />5 b✓'r•1 <br />PROPOSED USE OF BUILDING <br />�1�a.\ i N y�� � GgZ23 �"�1iDW 1�1'044 K M <br />Building Mechanfcal <br />PERMIT R Combfnation � Plumbing <br />TYPE � Demolilion Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK 1 C'y-�--� <br />�w <br />WORK DESCRIPTION <br />�AdJition <br />Allerellon <br />New <br />Repalr/Maint. <br />HEAT�SOURCE <br />�Eleclrb <br />Oes <br />Olher <br />CITY OF EVEREiT LOCAL SALES TA% CODE IS 3106 <br />1�.t1b11 �1 1'�'�' �►-�A'�LRI �►J�L� �\lU� '��vCB <br />NO. � TYPE OF Fl%TURE OR REM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. I TYPE OF FlXTURE OR fTEM <br />A/G — A/HANDLING CNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSErIT <br />(iAS FIREPLACE <br />(iAS RANCiE <br />OAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEFEBV CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SA'�1E TO BE TRUE AND CORRECT. AlL <br />PROVISIONS OF LAWS AND ORIDINACES COVERNING THIS TVI'E OF WORK WILL BE COMPLIE'� WITH WHETHER SPECIFIED HEREIN OR <br />NOT. TH TING OF A PERMIT DOES II T PRESUME TO OIVE AUTHORITY TO VIOLATE O'a CANCEL THE PROVISION OF ANY OTHER <br />STATE L CAl LAW gR�'cGU 0 S UCTION OP. THE PERFORMANCE OF CONSTRU�;TION. THAT I AM AUTHORIZED BY THE <br />CONT R T R S �y' p PE � W W�ORK FOR WHICH APPLICATION IS MADE Af ID I COMPLY WITH THE STATE <br />���� ---� 11—� � _ 0 1 <br />��� <br />