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SITE ADDRESS <br />-- , ��,��� <br />LEGAL LGT�NyO. <br />DESC. M r_ <br />.,..,.�,. J e�� <br />� �'�,�'�_ � �' � �� � <br />TENANTNAME <br />j— . � •_ � a. <br />CONTRACTOR <br />PHONE <br />P�RMIT APPLI�ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 n \ <br />�� ��� <br />PARCEL TAX I.D. # <br />• �.� �.. ) <br />BLOCK TRACT r <br />�" #� �cz<' z � �� � <br />0 f� �_l�: P. _ ADDRE55 Z�P <br />'M <br />i:t..� ,- , "-_ � I 1 <br />PROPOSED USE OF BUILDING <br />(�` �t � / <br />�� t' i � <br />I � �J ' ..1 ! ��� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />l� � ` ! <br />Foy� or � <br /># <br />� 0ly <br />Z i-�-4� CnZI S{ 17-� �j ,^?c' �(,C S{�✓;�v= <br />� <br />CONTACT FOR PERMIT PHONE •`� �11` j <br />C 1 1 �/`� rJ �IZ� ?�7�7 O'�',�UU <br />ADDRESS 21P CON'{n. LICENSE # <br />13AGr�2�\I. �$fr� � <br />�ilding Mechanical Addition HEA750URCE <br />PERMIT Combination Rl.-( Plumbing WORK Alteration II'—'(1� ectnc <br />TYPE �emolilion �J Sign 7YPE ew �Gas <br />L� Sprinkler Repalr/Maint. Ol'�er <br />y�• 1�-� �.� j `' j t S%/L , <br />PLUM81� <br />NO. I TYPE OF FIXTURE OR ITEM <br />0 <br />� <br />� <br />� <br />WATER CLOSET (TOILETj <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHN/ASHER <br />LAUNCRY TRAY <br />CLOTHES WASHE'.2 <br />URINAL <br />DRINKIN3 FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPfETC ) <br />OTHER <br />CITY OF EVERETT LOCAL SALES TAX CODE IS ]105 <br />NO.. I TYPE OF FIXTURE OR ITEM <br />�� <br />� <br />� <br />A/C-A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES CRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN / I/ <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ANO KNOV! THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED INITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AU7FIORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />SThTE GR LOCA�.LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED DY THE <br />O�PJNER OF JHI� PROPERJY TO PE L K FOR WHICH APPLICA ION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAGTORS LAW 18. 2' D^96.2001NAC. <br />l / / _^_- ir ,'� � ` ��/d `/ . <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�rz <br />