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�ERMIT APF�Ll�AT109V <br /> CITY OF EVERETT PERMIT SERVICES ' <br /> 32U0 CEDAR STREET, EVERETT, WA 9II201 <br /> 425-257-88�0 - FAX 425-257-�857 n� �� � � <br /> I <br /> SI7E ADDRESS PARCEL TAX I.D. :. /;E(h���I �� <br /> _���a�,�.t2��.R.�, �, U�:��.� -���,_�s�� -� , 1�_-1 lD= o <br /> _=:>LI LOTMO. CLOCK TRACT <br /> �_sr i' 3�SP o�-D — <br /> -�`---- <br /> OWNER ADCRE'iS ZIP PHONE <br /> (�-c`�c��R�_�c�,�!-��2i.s�s Lu- �'7o3a='��'t1ueS� 8oi'l� �t�so��. 4a�rZ�3 <br /> TflNANT�AM11E CONTACT FOR PERMIT PHONE t7� <br /> (._.�.�G..esSl� �12�5 - 1�13 -L"I (� <br /> --� <br /> CONTRACTOR ADDRESS ZIP �ONTR.LICEN:iE T <br /> (�-cka�cz C�rl.-1�-����s�.�i �-�-� ��1o�a-3s�'Au�SE Pvo�'r�.s� gs,��;- A9t�2.�2��3�e� <br /> PHONE <br /> PROPOSEO USE OF BUIL�INv uildiny f /Mechanical AaCrticn HEAT SOURCE <br /> ��„ � PERMIT �ombi'lalion FI-„--�YPlumbin3 WJRK �)e�atian Electrir. <br /> ���� �� TYPE Dem0lilion (J Sign Tl'PE evi �as <br /> ,_ftp��2:�� Sprinkler RepairlM1faint L� Other <br /> CONTRti7T PRICE GF WORK CIN OF EVBRETT LOCAL SALES TAX CODE IS 7105 � <br /> WORI(OESCRIPTIOiV <br /> �T 2,lty .�5. 1,n��`�2.� .�-0./4.�._.A.+-� -�1��cQ1J�_�- � a-�a'� <br /> PLUMBING � MECHANICAL <br /> N0. I TYPE OF FIXTUR[OR ITEM NO. TYPE OF FIXTURE OR�TEM <br /> �J I 'NATER CLOSCT(TOIL6T) AIC-AMANDLING UNITS . <br /> _�__i BATHTUB _L FORCED AIR SYSTEMS - <br /> t.�_I LAVATORY(!"IASH BASIN) _ HEAT PUMP ' <br /> SHO'NER UNIT HEATERS <br /> � RITCHEN SINK&DISPOSAL _f_ CLOTHES DRYER . <br /> _J� OISH4"JASHER � RANGE HOOD � <br /> WUNDRY TRAY _�_ WATER HEATER � <br /> � CLOTRES WASHER _ METAL FIREPLACElSTOVE � <br /> URINAL FIREPLACE WSERT ! <br /> DRWKING FOUNTAIN �_ GAS FIREPLACE I <br /> FLOOR DRAIN � GAS RA.NGE i <br /> _ BACKFLOW PREVENTER � GAS PIPING ; <br /> SINK(SERVICE'BAR%MOP/ETC.) EXHAUST FAN � <br /> -_ OTHER _� OTHER i <br /> =i _ = i <br /> —i — <br /> � <br /> I <br /> i <br /> -=RE3Y CcR1TIFV THFT I HAVE RE.4D AIvD E,�PMINED'HIS APPL!Ce�T10N AND KP:OW'HE SAtdE TO�E 7RUE PND CORRECT. FLL I <br /> �'�GVISIGNS OF LAWS.:ND GRIDINla;ES GOVERIJING THIS TVPE OP WORK IYILL�E COtdPLIED 1VITH\VHGTHER SPECIFIED HEREIN OR i <br /> :l'i. THE GRANTING OF 'r PERAtIT DOES tJOT�RESI?dE 70 GIVE AUTHORIN TO VIOL4TE OR CPNCcL TFE PROVISION OF ANY OTHER �� <br /> �'�aTe Oh'.LOCAL LAN'REGUW�ING CONSTRUCTION OR TNE PERFORAIANC�OF CONSTRIICT10N. THAt I dM AUTHORI�ED BV Tt,t <br /> - ::F:'tR•JF'HIS PROPER'"70 ?ERFORLI�HE`,VORIC FOR N�H!CH.1PPLICATiON i5 i.1.�DE AN�I CO;:rL':S'ITH THE STASE <br /> (�I i�R:.�:'OFS LA . 11i_� 'O�, r,�.� 29:100 A�kC <br /> - �.,� <br /> ��'l � <br /> �� �`�: -�i.—.; � ,rr.i� . ��!c c;l� hon�-.�� ,�r. _--- Data �� <br /> ..�F:��� . . i'.',-��i .',.�.C�J :iYt� iv(�i ;�l.i C� I �l7 <br />