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� <br />PERIIIIIT APPLICATION <br />CITY OF EVEI�ETT' PERMIT SERV�CES <br />3200 CFDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />SITE ADDRESS <br />a�/� �(�� ,�� <br />LEGAL LOT NO. k3LOCK <br />DESC. �,� � y g�' -.n o v <br />OWNER � I <br />, <br />� vres RXs °N I <br />TENANTNAME I <br />✓ _' <br />CONTRACTOR S -L' I � <br />PHONE ��` � <br />PROPOSED USE AF BUILOING <br />�- ��� <br />CONTRACT PRICE OF WORK <br />?ARCEL TAX I.D. k <br />�3 �i ,��o z � c� o c�� <br />TRACT i <br />ypy, o0 <br />ADDRESS �� / � i/ <br />�-� 3/�f 7; f�f `� ,x t<<- <br />GVIVIHG! IVHMt <br />ADDRESS <br />s�.� <br />Building Mechanical � <br />PERMIT Combination R Plumbing � WORK <br />TYPE � Demolition D Sign TYPE <br />Sprinkler <br />� <br />PERMIT rt <br />j PHONE I <br />; � z,� = ZS8- ?�38 �� � <br />PHONE i <br />! I <br />i CONTR. LICENSE fl <br />; <br />i <br />4tldition HEAT SOURCE <br />Alteration Q Electric <br />New �.,% Gas <br />RepaidMainL U Other <br />CITY OF EVERET'f LOCAL SALES TAX CODE IS 3705 <br />WORK �ESCRIPTION �^—� <br />�e�Gi�C?- C�i��� ✓ ���[�� Vrrc <br />r � <br />r�umnirv� mc�nHmc��� � � <br />NO. � TYPE OF FIXTURE OR REM �1,�� �� NO. I TfPE OF FIXTURE OR ITEM U� C <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOi�HES WASHER <br />URiNAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENiER <br />SINK (SERVICEi9AR/MOP/ETC.) <br />OTHER <br />A/C - FVHANDLING UNITS <br />FORCEO AIR SYSTEhiS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATEF NEATER <br />k1ETAL FIREPLACE.'STOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />G,1S PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CEFITIFV THAT I HAVE RF�1D AND EXAh11NED THIS APPLICATION AND KNOW THE SAh1E TO BE TqUE AND CORRECT. ALL � <br />PROVISIONS OF L4WS AND ORIDINACES GOVEHNING THIS NPE OF 4VORK WILL BE COh1PLIED WITH WHETHEii SPECIFIED HEFiEIN OR <br />NOT. THE GRANTING Of A PEPMIT DOES NOT PRESUME -0 GNE AUTHORIN TO VIOLITE OR CANCEL THE PROVIS!ON OF ANY OTHER <br />STATE OR IOCAL LAW REGUWTING CONSTRUCTION OR THE PERFORMAYCE OF CONSTRUCTION. THAT I AA1 AUTHOiiIZED BY THE li <br />O!NNEF OF THIS PqOPERTY TO PERFOfih7 THE WORK FOR WHICN APPLICATION IS MAOE AND I CCh1PLV WITH THE STATE <br />CONTRACTORS LAW 18 27 RGN AND 296200 WAC. <br />� '����-�� � � - Zc' - � / � <br />`IL <br />