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� PERMIT APPLlCATION <br />' CITY OF EVERETT P�RIIitIT SERVICES <br />j 3200 GEDAR STREET, EVEREIT, UJA 98201 <br />425-257-8E 10 — FAX d; 5-257-8857 (� ��j � <br />'7 <br />� SITE Annor-ec � <br />-7/F �c���� <br />I LtCiA LOT NO. I� 9LOCK <br />I CE _� _�L_ <br />� hWNFR <br />� v e re--i1' <br />7ENANT YAME <br />PARrE: TA% I.O. M <br />��t �,-o� ! - <br />TAACT <br />-�--� 1 D� Co`;�`L� <br />C017fl.CT FOR PF.RMIT <br />3 �- f <br />L <br />PcFAq:T + <br />98a�! 'i).S-3o3-�� <br />______"____—" P40N@ <br />_�Aw�� _ f 144 AntG�� _HJ,S-S't'L��LS 5'1._..- <br />CONTRACTOR /� ADDflESS c� IIP CONTA. UCEN: <br />LUPhO�'F{-UvS�UCo�-rt,T+OniTy �IUi�it•I�J� ��r� lYiOI <br />PHONE <br />Na-5 - 5ofr�-�5ti�. <br />PqOPOSEO US[ OF BUILDING <br />��� <br />CONTRACT PRICE OF WORK <br />��r))) Builtling �Pchan�ca' n Ad�alflon � HEAT OURCE <br />PEFMlT �} Combmaticn Plumb�ng WORK �e�aton � 6adre <br />7YP£ r� Dzmelition Siyn TYPE tiew � Gae <br />� SorinKler Fecelr�V��nt. Oifler <br />__ CITY OF EVEHETT l000.L SAL�S TAX CODE IS 105 <br />WONK DF.SCRIPTION Q� h • I y�,Q pX �S T7 �G Re-C `ciA NC C.. <br />-�_P � r RQ rv.�� <br />NO. TYPE OF FIXTURE OR REM - <br />� . 'NATFR Cf.OSET <br />�. BATNT.UB <br />', _ fAV�TORY fW.4SH BASIN) <br />:iIiQWER <br />_, KITCNFPJ SINK R DISPOSAL <br />__,Ip1SHWASNER <br />Lr.J:VDRV TFAY <br />' �! OT�tiES VJASHER <br />I __--� ut�iriti� <br />.___� f!PINKI^IG rQl)NTAIN <br />__ F�OC!i DRAi11 <br />__. 3ACKF�CW PREVENTER <br />_ SI'JK rSEp'JICE�BAR�MOPiETC.y <br />___ OTNER ___._� <br />--' � - ---- <br />--- � �-------'— - <br />i--�-- I -- ----- <br />fv0. TYPE OF FIXTURF pR ITEU <br />^__ A/G-iVHAWCLINGUNITS <br />__ FORCSD A!R SVS'Etv1S <br />HEAT PUIdP <br />UNI7 HEATERS <br />� C�OThES DRVER <br />�_ RANGE HGOD <br />L.. WA i ER hEATFR <br />_.___i �+1E�ALFIPEPLqCE.'STUV� <br />___� FIFEPLACE INSERT <br />_I �3AS FIREP�Cc <br />GAS RANGE <br />J_� GAS PIPING <br />3 � EXHAUST FA^; <br />� IOTNER ---_—_-- <br />—� "----------- <br />i h�cNFB� CEaITIFV THAT I HAVE REAC ANO EXAMItiSU ThIS APP'�ICATiDN ANO hN,^.7v TMF S4M11E `O BE TPUE AND CORPE�;1' <br />GFOVISIONS OF �.1WS ANOORiCINACES GU\'EaNING THIS 1'VPE OF'NORK W;LL 6E COMaLIEJ V:iTri �sVNE7N�R SPECIFIF.� HE IN �R . <br />`AT. THE GRAN71tiu OF A PERMIT CCES NCT r"FESUAAE TC GNE AUTNOR�TI' ?0 VIOI.iTE Of- CANCEI THE PFpVISiCN CF AN '�TNEr � <br />StA i F. OP LOCAL 13W REGU',.Ai1Nt3 CONSTRUCTION CP THE PE�FOAMANCE OF C�NS'PUCTION. T'nAT I AM AUTNOR�:EO BY H[ � <br />01'JNER OF THIS PFUPEPTY' TO ?EHFORM TNE'.YORK FOR WhICH AFPLICATION IS A1ADc 4N0 � CJMFI.Y ,4'ITH THE STA?E I <br />� C!dT�iAC7C(�S L41^: ' 427 RCVd AhD'186..'00 \VAQ , <br />J <br />DEBIT & CREDIT CARDS ARE NOT ACCEP�ED <br />