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�`�� <br />��'� <br />SITE ADDRESS <br />k3�2 0 ; <br />LEGA L'�T NO. <br />oesc. _ � G _ <br />OWNER <br />PE'�SMIT APPLICQTIO.. <br />CITY OF EVER�T�T PERMIT SERVICES <br />32U0 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-88�7 <br />� <br />BLOCK I TRACT <br />i�_T.nn i � <br />PARCEL TAX I.D. q <br />��� <br />PERMIT p <br />C c� aC�s-oCB- <br />�=u,NN� <br />PNONE <br />J�l,., ��r�-�orc1 �33� J�r'd, 8�k,% `'7fl�o�; y.�s._3�/)-/S3 S <br />TENANTNAMc I CONTACTNAME PHONE <br />\ ii .,-a i+ <br />CQNTRACTO.'7 <br />PHONE <br />PROPOSED USE OF BUIL�ING <br />AODRESS <br />Building Mechanical <br />PERMIT R Combinalion R Plumbing <br />TYPE D Demolilion ❑ Sigr. <br />U Sprinkler <br />CONTFACT PRICE OF WORK '�� / <br />WORK OESCRIPTION <br />�7�j J ,(�^i%i�. <br />/ /'l'LL. / <br />NO. � TypE OF FIXTURE OFi ITEM <br />_$_ WATER CLOSET // / <br />� BATHTUB / <br />�LAVATORY (WASH BASIN) //� <br />SHOWER J/ <br />� KITCHEN SINK 8 DISPOSAI. <br />_� DISHWASHER <br />LAUNORYTRAY <br />� CLOTHES WASHER <br />_ URINAL <br />DRINKING FOUNTAIN <br />_ FLOOR DRAIN <br />_ BACKFLOW PREVENTER <br />_ SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />I — <br />ZIP CONTR. UCENSE M <br />� �dCition I NEAT SOURCE <br />WORIC , .Iteralion Q Electric <br />TYPE I lew B Gas <br />�IepaiN�daint. Olher <br />CITY OF EVERETT LOC'iL SALES TAX COOE IS 3105 <br />NO. � TYpE OF FIXTUFE O i ITEM <br />A/C — A/HANDLING l NITS <br />� FORCED AIF SYSTE'NS <br />_ HEAT PUMP <br />UNIT HEATERS <br />�CLOTHE� DRYER <br />RANGEHOOD <br />� WATER HEATER <br />METAL FIREPLACE/S 'OVE <br />FIREPLACE INSERT <br />_ GAS FIREPLACE <br />GAS RANGE <br />� GAS PIPING <br />EXHA�STFAN //// <br />_ OTHER <br />� I HERE�Y CERITIFY THA71 HAVE READ AND EXAIdINED THIS APPLICATION AND KNOW THE SAME TO 8= TRU i t1{VD CORRECT. ALL <br />PROVISIONS OF L141B AND ORIDINACES GOVERNING THI& NPE OF WOFK WiIL 6E COMPUED INITH WHETf _R SPECIFIED HEREIN OF <br />, NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUAIE TO GiVE AUTHOFITY TO VIOWTE OR CANCEL THE 'ROVIS!ON OF ANY OTHER <br />STATE OR IOCAL L1W FEGULATWG CONSTRUCTION OF THE PERFORMANCE OF CONSTFUCTION. 1'HAT I Ar1 AUTMUFIZED BY THE <br />OWNER OF THIS PROPERTY TO PEPFORlA THE WORK FOR WHICH APPUCATION IS M1fAOE AND I COMPLY WIT I THE STATE <br />CONTRACTORS LA'N 1�.27 RCWPND 296.200 WAC. <br />