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SITE <br />DESC <br />� <br />PERMIT APPLICA .'ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />3E55 <br />'�y- �/�) �i��/ <br />LOT NO. BLOCK <br />TENANT NAh1E <br />TRACT <br />PARCEL TAX I.D. � <br />NAME <br />i- �y -a 3 <br />xc3c� -c�; <br />PERMIT q <br />, ,� . , . <br />CONTFACTOR ADORESS LIP CONTR. LICENSE'. q <br />�vcs s�z s P� lx� 3�� ► � Lrrxr�-�Av��ve�.t-►- l. i���� �,�,eS��P � <br />aHor�e <br />l� -� C� _ �Cq —_'�A SL T <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF 1YORK <br />WORK �[SCRIPTION <br />NO. I TYPE OF FI%TUflE OR ITEM <br />_� <br />WATEFi CLOSET <br />BATH7U8 <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRA'r <br />CLOTHES WASHER <br />UR�NAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACK�LOW PRcVENTER <br />SINK (SEFlVICElBAR/MOP/ETC.) <br />OTHER <br />Building Q Mechanical <br />PERMIT R Cambina!ioo � Plum6ing <br />TYPE D Demolilion Sign <br />U Sprinkler <br />E <br />� <br />�QQQ Addition I HEAT SOUACE <br />Al�eration j� Electric <br />New Gas <br />RepaidlAainl Olher <br />CITY OF EVER[Tf LOCAL SALES TAX COOE IS 3105 <br />NO. � TYPE OF FI%TURE OR I"!EM <br />� <br />/VG —NHANDLWG UNITS <br />FORC[D AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />FANGEHOOD <br />WATER HEATER <br />ME7AL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY'HAT 1 HAVE REAO AND EXA�dINED THIS APPUCATION ANJ KNOW THE SAME TO �E TRUE 4ND CORRECT. ALL <br />PROVISIONS OF L1WS AND ORIDINACES GOVEFNING THIS TYPE OF INORK WILL BE COMPLIED WITH WHETH[R SPECIFIED HEREIN OR <br />NOT. THE GFANTING UF A PERMIT DOES NOT PRESUME TO GIVE AU7HORITY TO VIOLITE OR CANCEL THE PROVISION OP ANY OTHEF <br />STATE ON" LOCAL LAW PEGULATING CONSTRUGTION OR THE P[RFORh1ANCE OP CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROP9RN 10 PEPFORM THE WOFK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br />CON7RACTORS LA1N (iB27 RCW .4ND 296200 WAC. <br />f , rtn.� II>>�X;n;���,,�) ( ' � �� � `i� �/ <br />