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SITE i <br />7 <br />LEGAL <br />DESC. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SEaVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />�t,^ 3 ,�,e Gv . <br />7 <br />LOT NO. BLOCK <br />�O(L2�t� <br />TENANTNAME <br />vs¢ <br />PARCEL TA7( I.D. # <br />TRACT <br />��{/7- � %��� ��� �t.2� <br />CONTRACTOR ���i�� �ID��J�j'T'S <br />PHONE <br />�/'1 S � t`'� •'i <br />CONTACT FOR PERMIT <br />/���,�P `b%�1_ <br />P�RMIT # <br />Mo <br />ZIP PHONE <br />� yas �a-5�6 <br />PHONE <br />Yas �a$-o�� _ <br />ADPr�S 2DJl /S36 ZIP CONTR. UCENSE # <br />`� CNea6-e � qa � k9 <br />.L�. Sf-e�eks, (�lJ�, lg�.f8 <br />PROPOSED USE OF BUILDING 9�.ilding �CMoCha�iCal I �AddiUon HEAT SOURCE <br />PERMIT ��ombinalion ��_� Plumbing WORK Alteration Electric <br />7YPE llemolilion LJ Sign TYPE New � Gas <br />Spnnkler Repair/MainL I L� Olher <br />CONTRACT PRICE OF WORK �Q� � CITY OF EVERETT LOCAL SAI.ES TAX CODE IS 7705 <br />WORK DESCRIPTION <br />�-�I /g('.e -e �(5 77�� �Ct 5 Gri4� f'leq 7�`' <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />OISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BARlMOP/F_TC.) <br />OTHER <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 />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL <br />PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHOFiITY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULITING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER F THIS PROPERTY TO PE ORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT �v� ��W � 2�^OOWAC. �^�^O� <br />8 CREDIT CARDS ARE NOT ACCEPTED <br />