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� <br />SITE ADDRESS <br />LOT NO. <br />Z <br />FcRMIT APPL1���4Tl..1N <br />CITY OF EVENETT PERD;IIT SERVICES <br />3200 CEDAR �TREET, EVEFETT, WA 98201 <br />425-257-8810 - FAX 4:?5-257-8857 <br />PARCEL TAX I.D. k <br />ZSoSo-� Do3o �o <br />BLOCK I TRACT <br />SCE .4rrqGki��j <br />PERMIT X , <br />JCO ad 7 -QQS <br />t�LUE L'thP f RS�1Jc��j fo"75 �a°fi�ti #Z4o4 .U�N4 /apf7 �Z1Z�(o�l b40b <br />TENANT NAME �'—�-- <br />CONTACTNAME PHONE <br />4"6u2.. �..6E1JC�P5 Zt�-i7�1 L <br />_ �ot� Siv,��, � o� `1�S 4ZZZ <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE N <br />ENco.L,.�Asa r����a�,c,a� �7�7 �6ruo�rq,�E Sw ysio� ��,coMrv 9a4c.tt <br />PHONE <br />ZOt�_•-1 fofi� • 4ZZZ <br />PFiOPOSED USE OF BUILDING <br />�M i <br />�-E`I'Ii�l L <br />CONTRACT PRICE OF WORK <br />Building Mechanical <br />PEFiMIT Combinalion � Plumbing <br />TYPE Demolition Sign <br />Sprinkler <br />� DOU— <br />Addition I HEAT SOURCE <br />WORK Alleration Electric <br />TYPE New �Gas <br />RepaidMaint. Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORKDESCRIPTION ONE NEt�) ZS-Zp» '�rky�p�y� �,�yy/� ��P �qC u,Vi�,� n1�1t.�i� <br />�"iPJIA�a� Q.�13\STt�S � i`�.- 1F'R7S6TL3� (�A-9 �T lP\Ua� Dlvrc NE�tJ ��7"A-�� ! SiT�1L%/��cJCEi <br />NO. � TYPE OF FIXTURE OR ITEL1 <br />WA�EH GLOSET <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 (SERVICE/8AR/MOP/ETC.) <br />L OTHER "DE,,,,u� �ES <br />Z �LF_7 ..t Fl�TF� /-Ir� c j{ g3 <br />_{_ ��� m �eOn ii. '[�.�p'_N L11JE <br />NO. � TYPE OF FIXTURE OR ITEM <br />� .wt,: - A/HANDLING UNITS <br />_ FORCED AIR SYSTEMS <br />_ HEAT PUMP <br />_ UNIT HEATERS <br />_ CLOTHES DRYER <br />_ RANGEHOOD <br />_ WATER HEATcH <br />_ METAL FIREPLACE/STOVE <br />._ FIREPLACE �NSERT <br />_ GAS FIREPLACE <br />_ GAS RANGE <br />� GAS PIPING <br />_ EXHAUSTFAN <br />_ OTHER <br />I HEREBY CERITIF`/ THAT I HAVE READ AND EXAMIPJED THIS APPLICATION AND KNOW THE SAM11E TO BE TRUE AND CORRECT. ALl <br />PROVISIONS OF L1W5 AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br />NOT. 7HE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL ThE PROVISION OF ANY UTIIER <br />STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE PEflFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERIV TO PERFORM THE WOPK FOR WHICH APPLICATION IS P:1ADE AND I COh7PLY WITH THE STATE <br />CONTRACTORS LAW 18.2? RCW AND 296200 WAC. <br />