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� <br />� <br />SITE ADDRESS r�� <br />�^ J (l �� �0/�i���'V.+ <br />�; �RMIT APPLICAT�� �N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />LEGA �/ LOT NO. � Z BLOCK <br />DESC. /✓C�i�it��� 2 H n��iJ—� <br />��F^' PARCEL TAX I.D. N <br />aos�y�o�aao Oi <br />TRAC7 <br />PEi;MIT A <br />� �oao�- <br />�.Hi�,e��s L.�ckC% 6Svy C��r�R� F�E�1� 98; <br />TENANTNAtdE — -- I CONTACTNAME PHONE <br />I:ONTRACTOR <br />PF10NE ��/N�� <br />PROPOSED USE OF BUILOfNG <br />CONTRACT PRICE OF WORK <br />AOORESS <br />Building <br />PERMIT �Combinalion <br />TYPE Demolitian <br />Sprinkier <br />RMechanical <br />Plumbing <br />D Sign <br />�3y <br />ZIP CONTR. LICENSE p <br />Addilion <br />Alteralion <br />New <br />FepaidMaint. <br />HEATSOURCE <br />D Electric <br />u �ae <br />U Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />y�%%(J �J` �..$� / r/'`� 9' �%i('/ttyl.: %Cl �i U/6- J N�`w <br />�� �r <br />NO. � TYPE OF FIXTURE OR REM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TP,AY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR CAAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER_ <br />NCt. � TYPE OF FIXTURE OR ITEM <br />A/C —A/HAIJDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />_ CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />_ FIREPLACE INSERT <br />GAS FIREPLACE <br />_ GAS RANGE <br />_ GAS PIPING <br />EXHAUSTFAN <br />_ OTHER <br />I HEREBV CEFITIFY THAT I HAV_ READ ANJ EXAMINEp THIS APPLICATION AND KNOW TH[ SAME TO BE TRUE AND CORRECT. ALL <br />P{iOVISI0N5 OF L1W5 AND ORIDINACES G�VERNING THIS 1YPE OF WORK WILL BE COMFLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT FRES�ME TO GIVE AUTHORITY TG VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE CR LOCAL LAW REGULA7ING CONSTRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE I\ND 1 COMPLY WITH THE STATE <br />CONTRACTOR$ LAW 18.D FiCW A/N� 296.200 WAC. <br />��/z,.,..G �-.� �,�,. �.c,_.,., 7 • 2 Z ' U2 <br />