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DEC-17-UI 10:54 <br />�' <br />FRO�-NORTHWEST-"SSIIM� 2U6-374-OB?4 _. T-A65 P.01/02 F-301 <br />P�ERMIT APPLICATivN <br />CITY OF EVERETT PERMI'f SERVICES <br />3240 CEDAR STREET, EVERETT, WA 98201, 425-257-8610 <br />SRE AO�RESS <br />3Sos an �► A�e <br />LEGAL L07 NO. BLOC <br />DESC. <br />OWNER <br />�ucK�� SvGY�.,r�i <br />TENANTNAME <br />�J � .9 <br />CONTRACTOR <br />c,�Gscu <br />PHOIVE Z� 6 - 2 f 1- Y� v v <br />PR6POSEC USE OF BUILDING <br />s F� <br />PARCEL TAX I.D. # I PERMIT 8 <br />Oo�11�3ov3uv� vo �o�ld-o[ <br />ADDRESS <br />3Pvs N�yt A�e <br />CONTACTNAME <br />Cc,�J.� r2 � „ll +g 4�✓ <br />ApORESS �t <br />2 fuo � v��r^aYt� J��c <br />S'ev�l, S°� F S <br />PHONE y�r <br />as�'-_53vy <br />�06_ PHONE <br />S��-66�a <br />CONTR. LICENSE p <br />C.�AJNI�r 5 5,B'c.-% <br />8uiltling FAechanica,' nddtion <br />PERMIT B Com6inalion g Piumbing WOAK � Alteration <br />TYPE �emolition U Sign TYPE New <br />Sprinkler RepaiunAa�nt, <br />�ONTRACT PRICE OF WOFtK %r 2 u v J <br />WOHK OESCAIPTION <br />HEATSOURCE <br />Eletitic <br />Ges <br />O;ber <br />CfTY OF EVERETT LOCAt, SALES TA7C CCDE IS 3105 <br />..�.II�y..y{ pw� �V�Y�O iS�K �41 *� 9tl �4��G0 <br />NO. I TNPE OF FlXTURE C�R REM <br />WATER CLOSEi <br />BA7H'U9 <br />UIVATOFiY (WASH B.iSIN) <br />SHOWER <br />KI iCHEN SINK & DISI�OSAL <br />DISHWASFiER <br />LAUNORY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN'CER <br />SINK (SEFVICElBAR/IdOP/ETC.) <br />OTHER _ <br />NO. � 7YPE OF FIXTUFE OR REM <br />� h�C—AMANGLING UNITS <br />� FORCED AIR SYSTEMS <br />_ HEAT PUMP <br />_ UNIT HEATERS <br />CLO7HES DRYER <br />RANGEHOOD <br />WATER HEA7ER <br />_ METAL FIREPLACE/STOVE <br />FIREPLn.CE INSERT <br />_ GAS FI!iEPi.RCE <br />_ GAS RF!�GE <br />_ GAS PIPING <br />, EXHAU57 FAN <br />OTNER <br />I HERE6Y CERITIFY THAT I NA�IE FEAD AND IXAMINEO THIS APPLICATION AND KNOW THE SAME TO BE TAUE AND CORREC7. ALL <br />PROVISICNS OF IAWS AND Of11DINACES GOVERNING THIS TYPE OF WOFK WILL 8E COMPLIED WiTH WHEfHER SPECIFIED NEREIN OR <br />NOT. TME GRANTING OF A PEI�MIT OOES NOT PRESUME TO GIVE AUTHORITY TO vIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br />S7A7E OR IOCAL LAW REGCL\TING CONSTRUQTION OR THE PERFORMANCE OF CONSTRUC710N. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PPOPERTY Td PERFOFM THE WORK fOR WHICH APPLICATION IS MApE �NC I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCIN AND 296200 WAC. <br />