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SITE ADDFESS <br />� <br />LOT NO. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-A.810 – FAX 425-257-8857 <br />�--16 -o� <br />PARCEL TAX I.D. � PERMIr e <br />'� r.. <br />� S'f— �t�STd i. –001 �Oc� O ^ODO `� i,� ' , � _� , <br />BLO(:K TRACT <br />urvrven n�vneoa ..i� �nvrvo L� Z� <br />�� t�it I-ia u s i„6 i�- v Trt�, Q� r� 3��'�- L o i h./ 9�� o/ �(7 /– J L l, I <br />TENANT NAME I CONTACT NAME y Z; PHONE <br />�1f1� � /�ill �l�NGtrS .So��.�L.�l <br />CONTRACTOR � f� n ADORESS ZIP CONTR. LICENSE p <br />"t <br />PHONE <br />PROPOSED USE O� BUILDING <br />SF-2 �.o✓'� <br />Buiiding hanical <br />PERMIT � Combination Plumbing <br />TYPE Demolition Sign <br />Sprinkler (a ot heads) <br />CONTRACT PRICE OF WORK ,�,/� � U= <br />WORK DESCRIPTION - <br />/Y� o �' �" n ! 2.�P �4-QO � /' <br />PLUMBING <br />@[��ii /7X�7.Yy1:ii9:l��l:lti_�ul <br />WATER GLORF'! (TOIL[T) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWGR <br />KITCHEN SINK & DISPOSAL <br />DISFIWASHGR <br />LAUNDRYTRAY <br />CLOTHES WASHEH <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />DACKfLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />Addition <br />Alteration <br />New <br />epair/Myinl. <br />HEATSOURCE <br />Electric <br />O�her <br />CITY OF EVERETf LOCAL SALES TA% CODE IS 3105 <br />/Oc.,-� i nc.� +-�•.� itio �,Sln�� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCEC :,Ifl CYSTE :^,S <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER ��p � <br />RANGE NOOD ��-<-�L_ <br />WATER HEATER �—p�'e� <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING �'1 <br />fXFIAUST FAN 3 �a'` ' <br />I HERE�Y CERITIFY THAT I HAVE READ AND EXAMWED THIS l�PPLICATION AND KMOW i HE SA61E TO BE TRUE AND CORRECT. ALL <br />PROVISIONS Of LAWS AND ORIDINACES GOVERNWG THIS TYPE OF bVORK WILL BE COh1PLIED WITH WHETHER SPCCIFIED HEREIW OR <br />NOl'. THE GRANTWG OF A PERM1IIT DOES NOT PRESU�IE TO GIVE AUTHORIN TO VIOLATE OR C�NCEL THE PROVISION OF ANY OTHEF <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PEFiFORM11ANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER QF THIS PROPERTI' TO PERFORM THE WORK FOR VVHICH APPLICATION IS A1AUE AND I CONPLY WITH THE STATE <br />CONTR/fCTORS LAW 18.27 RCW AND 296.200 WAC. <br />I r' <br />l___.__ <br />