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PERMIT APPLICATIO <br /> GiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETr, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> S �07 - v� �-- <br /> SITE ADDRESS � 3 J�� �NU«S i�i J�j, PARCEL TAX I.D.# PERMIT# <br /> ��ER6T wq �j��� 2���'�ioZ���`Y-v14,-DO �D4�o!- �Ol <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. �''G /� JE� L�L/1L PIICrZIJ��Oti 13�U/6Q <br /> OWNER ADDRESS �� wc�'0 Le!ZIP PHONE <br /> � N rOn/i �o.l 17) 1' REo L � ��/'.r�� �4'F <br /> � 9 I DEV6wPi-,F-�c ,r CO2� 31�7o pa 2T��••a o� �I 7l Y J 1� <br /> TENANT NAME I CONTACT FOR PERhiIT PHONE <br /> H�JRa^�E JPi�� tihfFotiiL• cvRn /�r�ni i�OL/1"'O 4yS-30y —/S �./ <br /> CON7RACTOR '1]��P ���zpR�J �1 /NC. A�DRESS � Ty w, ZIP CONTR.LICENSE# <br /> �` ,�-C l01 70 Q✓('- <br /> PHONE �1�� ���OL2✓lP/siL_( <br /> EnH�-ar wo- 9,��y� �2✓�PEniE ��i�.7 <br /> PROPOSED USE OF BUIL�ING I B�ildi�g Mechanical Addi(ion HEAT SOURCE <br /> PERMIT R Combination�Plumbing WORK �Alteration I7 Electric <br /> TYPE g Oemolition Sign TYPE New I� Gas <br /> Sprinkler Repair/Maint. D Other <br /> CONTRACT PRICE OF WORK �,}�C� �_ CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> / <br /> WORKDESCRIPTION !7�NuF/j�,y-u2� �'✓7 /^�17'Tj�L� [jy_S�ti'F_1J <br /> ID/-.,�rFi�.�l7iv� Sll•�--9G-� Fdti <br /> /M� r32�^-[ S P��� �2EtPo,�r4. �r�n�v�-�7r•r.� <br /> •J� C L��J� SU 4N' <br /> PLUMBING MECHANICR'_ <br /> NO. TYpE OF FIXTURE OR ITEM NO. TYPE OP FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-PJHANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> � CLOTHES WASHER METAL FIREPLACE/STOVE <br /> � _ URINAL FIF2EPLACE INSERT <br /> DRINKING FOU�TAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> II I <br /> I I HEREBY CERITIFY THAT I HAVE READ AND Ei(AMINED THIS APPLICATION AND KNOW THE SAA1E TO BE TRUE AND CORRECT. AlL <br /> PROVISIONS OF LAWS AND ORiDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED`NITH WHETHER SPECIFIED HEREIN OR <br /> N07. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUWTING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR12Ep-OY THE <br /> OWNER OF THIS PROPERTY TO P�RFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE S ftTE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. 1 <br /> i Signature of Owner/ContractodAuthorized Agent Date � i� I � <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED / ��� ��L <br />