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P�RMIT APPLICATIO�'V <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />SITE AD�RESS PARCEL TAX I.D. • <br />� PERMIT ft <br />��/v _�/%�SS/�L� JJ� vo1�.37.f �Zg _U3o -ob J(OIOR <br />oesc. I�V �/Z c�: 3 oI�3✓ �2 4 <br />OWNER <br />/� �/l��iY /.�r7C2✓N�-T� <br />TENANTNAME <br />CONTRACTOR <br />ZSC/�% I`�sirE�oT�a� <br />PHONE CKc ZUC—�jo _5 <br />�f7fS��2—{�7oU <br />PROPOSED USE OF BUILDING <br />�/-/ /�i' �c�-.,e a'TIrL <br />S'i �/ 6( C �Aavi ��-t � <br />CONTRACT PRICE OF WORK � <br />� � �6Xc-r T <br />ADDRESS <br />3 yi v —�t/.v-ss�.� �� <br />CONTACTNAME <br />ADORESS <br />�i ��� 3 7-.,s'1��= E <br />u/vo�/1i�iCC� � <br />� <br />�z.f zSz ���' <br />PHONE <br />CONTR. UCENSE N <br />iS �n�^��s�e 6 �c� <br />Building Mechan(cal nddition HEAT SQURCE <br />PERMIT Combination�Pl�:nbing WOqK iteranon .�Pf'EiectAc <br />TYFE Demolition Sign TYPE New C S Gas <br />Sprinkler qepair/Maint. � Other <br />9(� ��� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION �( r� �� �r r�,3 /-/ou St ��.,� f��1� <br />S/�EET �� - <br />� — � <br />PLUMBIN6 ..�........__. <br />NO. � TYPE OF FU(TURE OR ITEM <br />CLOSET <br />LAVATORY (WASH BASIN) <br />KITCHEN SINK 8� <br />DISHWASFiER <br />LAUNDRYTRAY <br />CLOTHES WASHEF <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEF <br />SINK (SERVICE/BAR/MOPlETC.) <br />OTHER <br />N0. I TYPE OF FlXTURE OR REM <br />A/C - A/HANDLING UNITS <br />FOFCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />�LOTHES DRYER <br />RANGEHOOD <br />WATER FiEPTER C�S l��: <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS Pi'ING <br />EXHAUST FAN ��� �'+ <br />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 GOVERNING THIS TYPE OF WORK \VILL BE COMPLIED WITH WHEZHER 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 CONSTAUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THFW� RK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br />CONTRACTORSJd�W 1827 RCW AND 296.20fTWAQ' <br />