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SITE ADDRESS <br />1I�31 r <br />LEGA LOT NO. <br />DESC. � 5- �' � <br />L.:., �a <br />TENANTNAME <br />CONTRACTOR <br />D�,y � N, -F� , i �, c <br />PHONE <br />N 7 C- 77f-G�// <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />I <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE'f, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />F �� �i <br />BLOCK <br />PARCEL TAX I.D. # <br />�13P y'�i 7 <br />TRACT <br />1 g 3/ M� LZ� u ra // <br />ICONTACT FOR PER IT <br />ADDRESS <br />IGGi-� 1��Fa�.� w <br />Building Mechanical <br />PERMIT � Combination �Plumbing <br />7YPE Dem01iti0n Sign <br />Sprinkler <br />P MIT # <br />� ��—�� <br />ZIP PHONE <br />�'Z0/ 4Z�ZSZ-Z4�� <br />PHONE <br />21P CONTR. LICENSE S <br />�J�� OAy�N/PN04�/CM <br />Addition <br />WORK Alteration <br />TYPE New <br />RepairlMaint. <br />HEATSOURCE <br />Electric <br />Gas <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION . <br />�2t� �a�� �„/n �/�� SOi✓,LP �•�< :ier. ST f-c AO-�fP <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER �✓�dr. .,.,�._� �. <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C-A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />i I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO DE TRUE AND CORRECT. ALL <br />i PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYFE OF WORK WILL BE COMPLIED WITH WHETHER 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 />ISTATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TNAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAGE AND I COMPLY WITH THE STATE <br />I CONTRACTORSIAVJ.18.27 RCW AND 296.200 WAC. <br />� <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />