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SITE ADDRESS <br />LEGA /yL0 NO. <br />PE. �MIT APPLICATIO. � <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />TRACT <br />PARCEL TAX I.D. # <br />� ` �vp3 � <br />� <br />J '7 !. '��". i <br />PERMIT k � <br />� �1��., �1:111� <br />Cy <br />_ ��_ �� <br />�RAu+ �,�.l�o�� Qo (3ox �n4 muki►�,� °��a�s 8 6-��0�-/ <br />TENANT NAME CONTACT NAME ^ PHONE <br />` I C�(�A N�' %fn� {1 O I` 1 'y�5' S7�a —lll7 4 <br />CONTRACTOR <br />7i�.�1� o� F Cc�, <br />PHONE <br />y�s- y3a'_�>�� <br />PROPOSEO USE OF BUILDING <br />CONTRACT PRICE OF WORK ��� <br />ADDRESS <br />pn, �aK �y <br />ZIP CONTF. LICENSE A <br />T.6UH o c� o9aN7 <br />p��lc; l��0 9a'a�r <br />rv�a- uilding tilechanical <br />P[RMIT �) Gombination R Plumbing WORI <br />TYPE D Demolition D Sign TYPE <br />U Sprink�er <br />i '' <br />WORK �ESCRIPTION /, ,� ; <br />-1 C' � <br />�c�u� CO.vS�2vC�i O� �, <br />�l. i 1 V� �% r! <br />NO. I 1YPE OF FIXTURE OR ITEM <br />WATER CLOSET � I <br />BATHTUB <br />LAVATORY (WASH BASIN) � / r' � <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAI' <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE.%BAR/MOP/ETC.) <br />OTHER <br />�Addition <br />Alteration <br />New <br />FepaidMaint. <br />HEATSOURCE <br />Electric <br />Gas <br />Other <br />CITY O� EVEREIT LOCAL SALES TAX COOE IS 3105 <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />/ <br />� <br />/ <br />� <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS ' <br />HEAT PUMP <br />UNIT HEATERS <br />^LOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE / <br />GAS RANGE / <br />GAS PIPING //�� <br />EXHAUSTFAN i% <br />OTHER <br />I HEPEBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAIdE TO BE TRUE AND CORFECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL �E COGIPLIED WITH WHETHER SPECIFIED HEflEIN OR <br />NOT. THE GRANTING OF A PERhllT DOES NOT PRESUAtE TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHEfi <br />STATE OR LOC.1l L1W REGUI�ITING CONSTRUCTION OR THE PERFORAtANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE'NORK FOR 4YHICH APPLICATION IS MADE AND I COh1PLY WITH THE STATE <br />