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' I PP I ` <br /> ��RM T A L CAT JN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.A PERMR M <br /> r►1o3oa -o�{ <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PMONE <br /> 1r1Ai?�Fn/F /�7(� 233� E� C2I.�o !NE Fi.�',6�'-�w.s�.9��0/ �����-ZS'2.313�C <br /> TENANT NAME I CONTACT FOR PERMIT �� PHONE <br /> _ s//i`�f' <br /> CONTRACTOR AODRESS aP CONTR.LICENSEk <br /> .Sa if71 �UN�uc70a/ /a9z7-2i1 Aa. J,E. <br /> PHONE C" /�jM/ <br /> c z 3 3 0 �F-� w f��8 <br /> PROPOSED USE OF BUILDING PERM�T B Sp nkleation� Plu b ng I WORK �..( RepeiriMlaint. „�QT sElecMc <br /> TYPE Demolilion Sign TYPE �,.,1 New u Ges <br /> U l, omer <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1YORK OESCRIPTION (�,�� <br /> [� <br /> QEpc�cc'n w,t�p /x�►T� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OP FlXTURE OR REM NO. TYPE OF FlXTURE OR REM ' <br /> WATERCLOSET _ A/C—A/HANDLINGUNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL _ CLOTHES DFYER <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY � WATER HEATER <br /> CLOTHES WASHER _ METALFIREPLACFJSTOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER _ OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERN�NG THIS TYPE OF WORK WILL BE COMPLIED WITH WHEiHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM E WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS B27 RC 296 0 <br /> 3/ � <br /> Signatur ned on nt Date <br /> DE81T & CREDIT CARDS ARE NOT ACCEPTED <br />