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P�.RMIT APPLICATI� ;V <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS <br />33o Y IZo��� <br />LEGA LOT NO. <br />DESC. <br />OWNEH / <br />�LL-Nr(,� LCw��S <br />TENANT NA <br />` . <br />�/ /t-r/ <br />BLOCK <br />TRACT <br />PARCEL TAX I.D. N <br />3 o y .. l�t ��t��� <br />CONTACTNAME <br />DoY-- L�--ll��� <br />CONTRACTOR " ADDRESS � <br />s r rz c�> �5.�� ��.,.- , � 7 d�,� w�w✓� � <br />PHONE <br />Wz� -3 �.� - o�z� <br />PROPOSED USE OF BUILDING <br />�GS ` G�-Gv�G'C � <br />JI � <br />Building Mecha�ical <br />PEpMIT B Combination R Piumbing <br />TYPE Demolition p Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK ��� � <br />a <br />- � �.5 _ <br />`1 g2.0 ( �5`�' (�`i�l� <br />PHONE <br />�lzs - 8 �n -S�Y� <br />ZIP CONTR. UCENSE M <br />98z�5 <br />Addition <br />WORK Alteration <br />TYPE ew <br />epair/A9eint. <br />HEATSOURCE <br />Eiectric <br />s <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />WORK DESCRIPTION ���M�N � j�� /� y f.."'�i,-L D�,.y,y��,1-�� <br />�� GC <br />N0. I TYPE OF FIICTURE OH ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SINK & DISPOSAL <br />TRAY <br />UR�NAL <br />DRINKING FOUN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. I TYPE OF fl%TURE OR ITEM <br />A/C - A/HANDLING UNITS <br />ORCED AIR SYSTEMS <br />AT PUMP <br />UN HEATERS <br />CLO S DRYER <br />WATER H TER <br />METAL FIRE CE/STOVE <br />FIREPLACE INS T <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CEFITIFY'HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFiRECT. ALL <br />PROVISIONS OF IAWS AND ORI�INACES GOVERNING THI:i TYPE 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 />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR 1'HE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF TNIS PROPERTY TO PERFORyi'THE W�RK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC�T6R$ LA�y 1827�RCW AI�B�2y6zoo wnc. <br />.� ����.lf�bZ <br />