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SITE ADDRESS <br />4�' p5 Q, <br />LEGA LOi NO. <br />DESC. 1 �,� <br />OWNER <br />�✓lr k <br />TENANTNAME <br />P�RMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CF_DAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />BLOCK � _ TRACT <br />TAX I.D. M <br />)OI 0007 <br />PERMIT <br />CONTRACTOR nuuraess <br />Rt�'o.S� �-..►�'r..,.%o� L.I.0 1715o T7t 5� S(�' itA <br />_`1 Z7 - .7'1 b- 1 /� <br />PROPOSED USE OF BUILDING <br />�f �:cc� <br />CONTRACT PRICE OF WORK <br />Bui�ding Mechanical <br />PERhuT Combination Plumbing <br />TYPE Demolition Sign <br />Sprinkler <br />PERMIT <br />iaS-3 y6 -�; <br />ZIP CONTR. <br />48x 7.2 <br />Addition <br />WORK Alteration <br />TYPE New <br />Repair/Maint. <br />N <br />HEATSOURCE <br />Eiectnc <br />Gas <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 1705 <br />WORK DESCRIPTION � <br />Rw.,.,,c /�o.,- C.M�-'m.�..A-, �r..��er� � Ee�l.r,e Ertts�:� C...p.��!- <br />N0. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY �WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPlETC.) <br />OTHER <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STO:'E <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIFING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND E.YAMINED 7HI5 APNLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO 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 THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERN TO PERFORht THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW is.27 RCNLAND 296.200 WAC. <br />�L <br />DE81T & CREDIT CARDS ARE NOT ACCEPTED <br />