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SITE ADDRESS <br />G�? �� <br />LEGA LOT N0. <br />GEo�eGE <br />TENANTNAME <br />� ERMIT APPLICAT'lJN <br />CITY OF EWERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />23 /p 2�( PARCEL TAX I.D. N <br />A��viF� <br />BLOCK TRACT <br />ADDRESS <br />PERRY ZS✓/ RA�Ni�� ,cv�•rl� <br />CONTRACTOR <br />D.t i t N/6N7` <br />PHONE � wN'EQ hs <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />ICONTACT FOR PERMIT <br />Pl4q��ro ADDRESS <br />L � <br />wFG L� � y�+ 4•na <br />PERMR <br />TYPE <br />j� Building <br />rs Combination <br />BDemolition <br />Sprinkler <br />BMechanical <br />Plumbing <br />D Sign <br />aP <br />PERMIT N <br />uzr) uaz-2&�' <br />PHONE <br />CONTR. LICENSE M <br />j� Additlon <br />r•-t qlteretion <br />E.� New <br />l.J RepaiNMaint. <br />HEATSOURCE <br />�Electric <br />Ges <br />Other <br />CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORKOESCRIPTION ���AOf Co[P w.�TE,Q f'r�,.. %� e�cr ��yo Gi4pl�sc "� <br />Lo7�yC , f�o•�, �/ Co�op rk �� 70 /%H " 7i� e�yp/ x i� c•rowlsPa�e u+� o� <br />w� Y� �,� To 2�Y�7 23'T� C'o77v9C , r� st4 rc /Qe u(Fk 1%G�vct lvr �l `� ��KQXP <br />�v Rec��c� y3.Qf,. F/�.CStr✓� y'o 30� S�4Ya1�'{ af� ✓Q���s To C�" <br />NO. I TYPE OF Fl7(TURE OR REM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />I:ITCHEN SINK 8 DISPOSAL <br />�ISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />N0. I TYPE OF FlXTURE OR ITEM <br />A/C —A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACFJSTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />1 HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE 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 THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC ORS LAW 18.27 RCW AND .200 WAC. <br />_. � �� Nlt}��3 <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />