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SITE ADDRESS <br />(�;� i tor �i- I°� 3� <br />LEGAL LOT N0. <br />OESC. <br />OWNER <br />�w��'rc� H. N. <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />SCG�E6�i r �� •o /-'^/� l,.icT <br />PARCEL TAX I.D. k I�a �TIOr Or <br />W�`��' Do5G323SG0a(o( <br />�2�4� <br />coNrRncToa Nn c�A��l Gars7' <br />PHONE �{ l j U J7- ^ i�/sO <br />ADDRESS <br />2�3�—K�Gt� c� <br />CONTACTNAME <br />ADDRESS <br />(,�9G� <br />PERMIT # <br />E`�'-•eCT%- O/l^0 ( <br />PHONE <br />r. � L-� y, u <br />PHONE <br />CONTR. LICENSE N <br />213L /��l(,�+1�1,-� � r"Z7. ( N��/3�K�`23o�y <br />PROPOSED USE OF BUILDING Building � Mechanical Addition HEAT SOURCE <br />PERMIT �Combination Plumbing WORK � Alteration rj Electric <br />TYPE Demolition Sign TYPE New D Gas <br />Sprinkler Repair/Maint. D Other <br />CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL �ALES TAX CODE IS 3705 <br />WORK DESCRIPTION �r� % � �� ��� �� / <br />X <br />N0. I TYPE OF Fl7(TURE OR ITEM <br />WATEF CLOSET <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 />F100R DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />N0. I TYPE OF Fl%TURE OR ITEM <br />A/C — A/HANDLING UNITS <br />� FORCED AIR SYSTEMS <br />HEATPUMP <br />UNIT HEATERS <br />t CLOTHES DRYER <br />v RANGE HOOD <br />''� WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIFiEPLACE INSERT <br />GAS FIREPLdCE <br />GAS RANGE <br />� GAS PIPING <br />� EXHAUSTFAN <br />I HEaE9Y CEFIiIFV THAT I HAVE RE1D ANO EXAbtINEO THIS APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIGNS OF LiWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br />NOT. THE GRA4TING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOWTE OR CANCEL THE PROVISION OF ANV OTHER <br />STATE OR LOCAL LAW FEGULITING CONSTRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BV THE <br />OW�ER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 256200 WAC. <br />