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P�RMIT APPLIGATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS � I Zy S�Or S% S W <br />LOT NO. � BLOCK <br />DESC.r ' "7 <br />OWNER <br />� � 2cz.� 3 S <br />TENANTNAME <br />� i�( o.� e_ <br />PARCEL TAX I.D. # <br />%3l%— ��DI�]— <br />TRACT <br />l�c.NlL�,,7p2SN 1-1� <br />oa 1MA�22��-� 3�� <br />CONTACT FOR PERMIT <br />E� oc-5o �-t <br />S �� <br />� <br />n <br />����t y zs 5og <br />RR1�cJ3 ���s3 <br />PHONE <br />�1z� z�q i31i <br />CONTRACTOR .�— /_A �,� � L, S�DRESS 27� r(V ���r � JQ Z�P CONTR. UCENSE # <br />{�/�C�a- �� V %gZJI <br />PHONE �IZ� Z.��,1 1-��� PA���U1o9�dSrl <br />PROPOSED USE OF BUILDING <br />I�iC. � G��-1-1.Z� <br />�JA 2 �} Cr_`� <br />CONTRACT PRICE OF WORK <br />Building Mechanical <br />PERMIT � Combination R Plumbing <br />TYPE Demolition � Sign <br />5prinkler <br />�Addilion <br />Alteralion <br />r'nw <br />Repair/Maint. <br />HEATSOURCE <br />�ElecVic <br />Gas <br />Other <br />I�—7 � j— I CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />/ L -- <br />WORK DESCRIPTION � � ^ J � L�\„ <br />D C. i A C.�—\ f.� �A 2q l.r� —✓� <br />NO. I TYPE OF FIXTURE OR iTEM �, � <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BARlMOP/ETC.) <br />OTHER <br />NO. <br />TYPE OF FIXTURE OR ITEM �I � <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNiT HEATERS <br />CLOTHES DRYER <br />RANCE HOOD <br />WATER HEATER <br />METAL FIREPLACElSTOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPiNG <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAG4INED THIS APPLICATION 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 SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A FERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOFMANCE O�' CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS iAW �827 RCW AND 296.200 WAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />