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P`�RMIT APP�ICATI(;>��1 ' <br /> CITY OF EVERETT PERMIT SERVICES � <br /> :�'�00 CEDAR STRcET, EVERETT, WA 982U1 <br /> �125-257-9810- FAX 425-257-8857 <br /> SITE ADDRESS � /� � ��� �� PARCEL TAX I.D.# P�RA1iT n � <br /> _ iL�3 a-. 5�. E��c�.�t't���� -- � L �0 7 'c,r��—I <br /> . . . LOT NO. BIOCK TRACT � <br /> -:. <br /> � ,��'.EFi AO�RESS ZIP PHONE �� <br /> TE'iA!!T NA41E CON7ACT NAME PHONE I <br /> ���5 f��� S �6-�v-�� yc�f�2"Z—> ►IL`Z I <br /> CON7RACTOR ADDRESS ZIP CONTR.LICENSE N <br /> -r��,�� rz-� 2'73p �i �-�-w<L ��. s . r�a��o�-3��Qs <br /> PHONE� Z� I��L'L__ ���l� l V v r \ � � �� � I <br /> Z�n7i <br /> C90��E OF BUIL�1�lG ('� BuildinJ �Pdfch,7niC�l �Atltlition MEAT SOURCE I <br /> PEfiM111T I�-1 COmbinalion Plumt�ing WORK Alter�non Flectnr. <br /> 1 �� I 7YPE F_� Demoliticn S�gn TVPE New I R�( Gas <br /> LJ Spnnkler Fepav.l.lamt Ll Oiho� <br /> C.^.:TAACT PRICE OF WORK j -�jpp � � CfTY OF EVEflE i f LOCAL SALES TAX COOE IS 3105 ' <br /> '.tiORK DESCRIPTION . <br /> �i`SSZ�I.�-- �� U��l, 5 �Lt� . ' <br /> PLUMBING MECHANICAL I <br /> �_ � TYPE OF FlXTURE OR REfd NO. TYPE OF fIXTURE OR ITEM I�, <br /> � . '�"/ATER CLOSET A/C—AlHANDLING UNITS � <br /> � 9ATI-�TUB FORCED AIR SYSTEFdS � <br /> LAVATORY ('NASH BASIN) HEAT PUMP � <br /> =j SHOV/ER =I UNITHEATERS � <br /> KiTCHEN SItJK 8 DISPOSAL CLOTHES DRYER �', <br /> _ DISHWASHER RANGE HOOD i <br /> LAUNDRY Tr�A'f I WRTER HEATEP. I <br /> I, CLOTHES WASHER MEfAL FIREPLACFJSTOVE � <br /> URINAL FIREPLACE INSERT <br /> � �R�NKI`JG FOUNTAIN _ GAS FIREPLHCE <br /> ' PLOOF DRAIN GAS RANGE i <br /> � 5ACKFLOYJ PREVEN7ER GAS PIPING �, <br /> SINK fScRVICE8AWIAOP�ETC.j EXHAUST FAN I <br /> OTH.Ea OTHER <br /> , — — <br /> _ ' _ � <br /> i <br /> ��� =c3Y CEAIiIF/THAT I HA4E REi.O FND E1LAIdINED THIS APPLICATION AND KNOW THE SAIdE TO BE TRUE AND CORRECT. ALL <br /> � . .�S�C'1S OF LF7lS PND OPIGINn:.cS GO`/ERNING THIS TYPE OF WORK WILL BE COhiPLIED`NITH WHEfHER SPECIFIED HEREIN OR ' <br /> . ." ?HE GRANTt:G C'F A PERIAIT DOES'JOT PRESUtdE Tp GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> . "_ OR LOC?L LA'!!PES'iULA i ING CONSTRUC7i0�J OR THE PEPFORfdANCE OF CONST�iUCTION. iHAT I AM AUTHORIZED BV THE <br /> .. ,E�CF i r11S PPOPEA i/TO P£RFORld THE'NORR FOR'PlH�CH APPLIGATIOId IS 1dADE AND I COMPLY N/ITH TRE STATE <br /> . . =�CTORS ^ �22i qC'P/Atl�235 200 WAC. � <br /> � ' ` � � �� I <br /> ,�.� :'�..re � e�.�ctcr:.,,t^,.^,:a,1 ,enl Date � <br /> � 7 0 �-0s� I <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED �,0� <br /> _ --------- - - --- <br /> ��Z <br />