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P�.�MIT APPLICATIC�.J <br />CITY OF EVEREIT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS ,/� <br />o2�Oli /�G��n� er %�Q <br />LEGA LOT NO. BLOCK <br />DESC. <br />OWNER <br />�i�� 5����� �� <br />TENANTNAME <br />CONTRACTOR <br />✓�a���`� N.w, co��sr <br />PHONE <br />µ z r 3 S k- z-d�� Z- <br />PROPOSED USE OF BUILDING I <br />�,p� � � S.�f �- <br />CONTRACT PqICE OF WORK <br />WUfIR OESGHIPTION <br />%� �ttiJ 1�0 � � <br />N0. I TYPE OF FlXTURE OR REM <br />_ WATER CLOSET <br />_ BATHTUB <br />_ LAVATORY (WASH BASIN) <br />_ SHOWER <br />_ KITCHEN SINK 8 DISPOSAL <br />_ DISHWASHER <br />_ LAUNDRY TRAY <br />_ CLOTHES YJASHER <br />_ URINAL <br />_ DRINKING FOUNTAIN <br />_ FLOOR DRAIN <br />_ BACKFLOW PREVENTER <br />_ SINK (SERVICE/BAR/MOP/ETC.) <br />_ OTHER <br />PERMIT <br />rrve <br />IPARCEL TAl( I.D. N <br />TRAL.T <br />ADORESS <br />�Zc.t`�, ��� ���.W-t <br />CONTAC7NAME <br />ADDRESS <br />✓��S�X /(��/-3 �1a�� <br />j''�Building � Mechenicel <br />r-i Combination Plumbing WOR <br />6 Demolition Sign Typ� <br />D Sprinkler <br />PERMIT M <br />f�??l�g' <br />¢zr) 2� ,"-3 3 � <br />PNONE <br />ZIP CONTR. UCENSE I1 <br />9J�7� <br />� � �i� c /F�lcq <br />�Addition HEAT SOURCE <br />Altaration D Electnc <br />New D GBy <br />RepeidMainl. � Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />N0. I TYPE OF Fl7(TUqE OR Il'EM <br />'vo —wriANUUNG UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANCaE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AN� KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF L4WS AND ORIDINA GOVERN�NG THIS TYPE OF WORK WILL BE COMPLIED WITH WHE7HER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT OE NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PpOVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATIN STRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS �TYT9 p THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTR��182YRCy11 gg, 0 WAC. <br />