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4 <br />SITE ADDRESS <br />�:..J C-e <br />LOT NO. <br />����nir s����a�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />U� <br />BLOCK TRACT <br />PARCEL TAX I,O. / <br />PERMIT N <br />h c� Sd i <br />ur rnvnt ll ] $ ' <br />�yr � 1.� �,�, � e I k�z �,� c r� � S w+� h�� s� 3 �� c.ea.. {�v-t °' ��� 3 3� g•�� <br />7ENANTNAME CONTACTFORpERMR PHONE <br />I�If�� �Il'�'�.5� '\�-s'�l I.OU`t` <br />CONTRACTOR +�1�I m 1 � /�ppqEgg :Ip CONTR.LICENSER <br />PMONE �'Y�Q LhO,..r�' ��M a. I-1 1� lo lo Fz' (J� t�J � O I y mn"m� i3J a <br />PROPOSED USE OF BUILDING <br />�G VR/K/�GT �YNIGEOF WORK <br />WORK DESCRIPTION <br />�"c/YY uV '� <br />�,�.�w..%IU��Tef�ACA. `��`"�3 <br />Building Mechanical <br />PERMIT R Combinatian Plumbing <br />-TYPE ❑�Demolitlon � � �Sign <br />D Sprinkler <br />�Additbn <br />NtenUon <br />�W <br />RapailAleint. <br />MEATSOURCE <br />D EbcMc <br />n� <br />�CIA'�OF�EVERETT LOCALSALE3 TAX�CODE IE 5106 <br />� 2�1 c`�.e.. �x i s-� ; �.-�.6 c�o, S-��r r c� �e, <br />'NO. �I iMPEOFfUtFUREOR�fT£M <br />WATER CLOSET <br />— snrHTue <br />JIVATORY(WAS4 BASIN) <br />SHOWER <br />�KITCHEN�SINK S�DISPOSAL <br />DISHWASHER <br />IAUNDRY TRAY <br />�6LOTHES�WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />�FLOOR�DPo41N <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPlETC.) <br />_ OTHER <br />'NO. �� -fiYPE9FfOtiURE9R�tTEM <br />Alc: — AMANDLING UNITS <br />�FORCED AIRSYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />�CLOTHES�DRYER <br />RANGEHOOD <br />WAIER HEATER <br />METAL � FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />�GAS�RkNGE <br />GAS PIPING <br />EXHAUST AN <br />OTHER � A S ��('r�o�cQ <br />i�HEREBV�C'eRITIFY THATi HAVE READAND EI(AMINED 1HIS APPLIGATION AND�KNOW THESAME TO BE TRUEANU�GORREGT. #LL <br />PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS IYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIF�ED 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.OR1pCAL l.qW_REGUUli7NG.CONSTRUCTIPN.OR Tt1E PERFORMANCE.QF.CONSTRUCTION. THATJ.AM.AU.iHORIZERBY THE <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WMICH APPLICATION IS MADE AND I COMPLY WITH TFIE STATE <br />CONT�3i.C7\O�S LAW 18.27 RCW AND 2�6.200 WqC, <br />1 <br />DEBIT 8 CREDIT CARDS ARl: NOT ACCEPTED <br />�� <br />