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r <br />� <br />�. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR 3TREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />g�TE AO�RES9 <br />3t�q Muk�(,T�eo 3ivD <br />IEGA LOTNO. <br />DESC. <br />f F.R <br />�aul S�qe� <br />TENANT NlJ�AE <br />WA�1-�lYl�`{r� Ce <br />P�p Ca `�$,Z � <br />PROPOSED USE OF BUILDING <br />CpNTRACT PRICE OF WORK <br />BLOCK <br />3l� <br />WORKOESCRIPTION • <br />o�.� S-%-1 � � v�� <br />NO. I TYPE OF FlXTURE OR ITEM <br />pARCEL TAX I.D. • <br />DoS� 17ooS <br />TRACT <br />MuKil�o`�lU� �Cuer�f � <br />CONTACT FOR PERMR <br />ca�« g�Ga <br />AODRE�O <br />n Buildinp <br />PERMIT � ��S Combin9tion <br />TYPE DBR105tlOn <br />Sprinkler <br />.� <br />. <br />� <br />Ca <br />PERMR N <br />rno3� <br />�ZS 355-211o(p <br />a,� 2$� y�� <br />ZIP CONTR LICENSE / <br />qbi'S5 c.�tt��r�J � <br />�Meehanical Addilbn NEAT SOURCE <br />lumdng WORK Ntoretlon Q, Ebddc <br />Sign TYPE New 1�SlGae <br />RepalUMalnl. LJ omer <br />CITY OF EVERETf LOCAL SILLES TAX COCE IS ]105 <br />� r.� P f 4�e .Jrt�-f 4�I f�.s P i Pi n�- <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBARIMOP/ETC.) <br />OTHER <br />N0. � TYPE OF FIXTURE OR ITEM <br />A/C — AlHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPIACE INSERT <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />S: <br />I HEREBY CERITIFV THAT I HAVE READ AND 'c%AM�NED THIS APPLICATION AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL <br />PftOVIS10NS OF IAWS ANO ORIDINAGES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WMETMER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTMER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TMAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPIY WITH THE STATE <br />CONTRAGTORS LoWM8.217 RCW AN� 296.2�WAC./ T t�/C/^ ? <br />// nl // \ <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />£'d L586LS252bi��1 <br />:woa� es��t seea-s-naN <br />