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SITE ADDRESS <br />2 Co05 <br />LEGAL LOT N0. <br />DESC. <br />PE'RMIT APPLICATIOnI <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />Z�Sf 5j• <br />BLOCK TRACT <br />PARCEL TAX I.D. # <br />5-le�e� N1. l,�cc.�or1 ( p�o� Hol(7 l��e� LK ���vcv�S 4 kZS$ <br />TENANT NAME CONTACT FOR PERMIT <br />C�,��d 1��11;5 <br />CONTRACTOR ADDRESS Z�P <br />Da�i�'s lu�s�'alla-�rb✓��Crc,�i+ 5��� <br />PHONE <br />2 S�j' �l(� I <br />PROPOSED USE OF BUILDING <br />{�C S IG�.+^ C �. PERMIT <br />TYPE <br />CONTRACT PRICE OF WORK <br />�Building <br />Combination <br />Demolition <br />Sprinkler <br />RMechanical <br />Plumbing <br />D s�9� <br />l7S d�-�] ; <br />N25- 33y-G�C•8 <br />PHONE <br />CONTR. LICENSE # <br />Addition <br />WORK Alteralion <br />TYPE New <br />Repair/Maint. <br />HEATSOURCE <br />Electnc <br />Gas <br />other <br />CITY OF @VERETT LOCAL SALtS ?AX CODE iS J105 <br />WORKDESCRIPTION �r�S'IA��inG� G�G�S ��h�CS (�`� �i)t'P��cF I/1$PJ�i � Gif.CS iio'f" l,�:r;cfC: <br />�1 � <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORI' (WASH BASIN) <br />SHOWER <br />KITCHEN SINI( & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPIETC.) <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 />` hdETAL FIREPLACE/STOVE <br />� FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />� GAS PIPING <br />EXHAUSTFAN <br />I HEREBY CGRITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF'�.NGRK WILL BE COMPLIED WITH WHETHER SPECIFIED HcREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME i 0 61VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIC�� OF ANY OTHER <br />STATE OR LOCAL LAW REGULA7ING CONSTRUCTION OR THE PERFORA4ANCE OF CONSTRUCTION. THAT I Alvt FUTHORIZED BY l HE <br />OVJNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH'HE STATE <br />CONTRACTORS W'18.27 RC1N AND 296.200 WAC. <br />�I7,t;';:� sl��lzo�� <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />