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SITE ADDRESS <br />/O/0/1/s�G� <br />LEGA LOT P <br />DESC. � <br />�� <br />�ERMIT APPLICAT�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />�f! ��i f/%1��.� <br />TENANTNAME <br />CONTRACTOR <br />PARCEL TAX I.D. N <br />�• �GOY6 y7OG� 5�600 <br />BLOCK TRACT <br />���r,e6a�l��- � <br />ADDRESS <br />��� �,���"%' ` z�xe- <br />CONTACT FOR PERMIT <br />T7��f�tij/� .,�'ric <br />�in.I....l ADDRESS <br />PHONE ��GG� 7lCI %�ar <br />Gci // <br />3��1' o= � <br />8� J'Z �� <br />�var) 3�s z��n� <br />PHONE <br />���� �>y ��a.s— <br />ZIP <br />7D� �,Ul� ��n2—�/�.��Iro�. <br />�•O � ,d'x• /2 � % f G�/q. y��7Z <br />CONTR. LICENS'c A <br />� ffi✓l��/�!� <br />2Z000 <br />PROPOSED USE OF BUILDING Building fl Mechanical Addiiion HEAT SUURCE <br />PERMIT Combinalion �-� Plumbin WORK Altzration Q Electric <br />�� L� �j�,��. �%>, • TYPE Demolition �� Sign � TYPE � New �j Gas <br />�.,1 J,C, <br />i7 � Sprinkler Repair/hla�nt. L� Other <br />CONTRACT PRICE OF WORK �O� �-� OU CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />WORK DESCRIPTIO{N— <br />i-��.%t/1'.�-�� �N.!/�� ��r� �r i��� <br />l_ � <br />N0. I TYPE OF FIXTURE OR ITEM <br />_ WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHEFi <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPlETC.I <br />OTHER <br />NO. I TYPE OF FIXTURE OR ITEM <br />fVC - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEATPUMP <br />UNIT HEATERS �y � <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I NAVE READ AND EXAtdINED THIS APPLICATION AND KNOW THE SAAQE TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK INILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEFA1IT DOES NOT PRESUtdE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGUWTING CONSTRUCTION OR THE PERFORh1ANCE OF CONSTRUCTION. THAT I A�d AUTHORIZED 9Y THE <br />OWNER GF THIS PROPERTY TO PEFFOR�d THE WORK FOR WHICH APPUCATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTU�F�6 LA6Y 18.?�7 RC'�V-�1ND 296200 WAC. <br />i <br />�-�ll n' r (/ <br />" .% /I. �,% J I` �% �� � /J D3 <br />DEBIT & CREDIT CARDS ARE NUT ACCEPTED '�L <br />