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SITE ADDk'.SS <br />5�31 Lc <br />LEGAL LOT NO. <br />DESC. �, <br />d� <br />� <br />PCRM�T APPLICA�'IUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CED.4R STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX I.D. # <br />BLOCK TRACT <br />iv L���.�. �I�� <br />P�MIT� / <br />C, � v� — v� �� <br />7�v� � i'I-<—y Sc�M � <br />TENANT NAME COtRTACT FOR PCR�d1T PHONE �'7'GO � <br />-- (l� �-1-�c-t� �(��L� �, LJ1G 2�r� 651— i�r3 9 <br />CON I'RACTOR ADDRESS ZIP CONTR. LICENSE # <br />PHONE <br />(�j w YJ�. <br />PROPOSED USE OF BUILDING <br />SiIJ.C,�� FAMi�Y R�S <br />—�j Building Mechanical <br />PERMIT j� Combination R Plum6ing <br />TYPE Demoli'ion D Sign <br />B Sprinkler <br />Ad�ition <br />VJORK Af�eration <br />TYPE N�:w <br />P,epaidMaint. <br />HEATSOURCE <br />�El=ctric <br />Gas <br />Other <br />CONTRACT PRICE OF WORK � 1�, I�.�� �( �� � � I CITY OF EVERC-TT LOCAL SALES TAX CODE IS 3105 <br />r __ <br />WORK DESCRIPTION � <br />�� 4� { 1"')O ��� C!!10 t� c,f_ <br />I5T �L(t - P�-aGA7� UTI�ITY fZ<aoM, l��70 51oia$ An,o 27x2Z� G.akAGE <br />2„w1 F�2 � AbD 2 REdRO�MS � �AI+�Pt!"l� �cl��� RA'Tii/z�o"+ _ <br />PLUMBING MECHANICAL <br />Nq. I TVPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (INASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES V'JASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. I TYPE OF F�Y7URE OR ITEM <br />A/C — A/HAN�LING UNITS <br />FORCED AIR � rSTEMS <br />HEAT PUMP <br />UNIT fiEATERS <br />� CLOTHES DRYER <br />RANGEHOOD <br />� WATER HEATCR <br />METAL FIFEPLACEISTOVE <br />FIREPiACE INSERT <br />GAS FIREPLACE <br />GAS RANGF <br />GAS PIPING <br />�— EXHAUST FAN �/ <br />OTHER <br />I HEREBY CEkITIFY THAT I HAVE READ AIJD EXAMINED THIS APPLICATION f1ND F:NOW THE SAME TO �E 7RUE AND CORRECT. ALL <br />PROVISIONS OF LFWS AND ORIDINACES GOVERNING THIS.TI'PE OF WORK WILL BF C01�iPLIED WITH WHETHER SPECIPIED HFREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUh1E TO GIVE AUTHORITY TO VIOLATE OF CANC=L THE PRCVISION OF ANY OTHER <br />STATE OR LOCAL LAW RE �ULATING CONSTRUCTION OR THE PERrORMANCE OF CONSTRUCTIOtJ. THHT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEFTY TO PERFORA1 THE WORK FOR WHICH APPLICATION IS MADE AND I COMPL'f WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.�00 WAC. <br />-/ �-CJ <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />