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a <br />P�RMIT APPLICAZ'ION <br />CITY OF EVERETT PERIV�17 SEZVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 � <br />SITE ADDRESS <br />.�u� F���' �c�c w. <br />LEGA LOT N0. BLOCN <br />p�;� r <br />TENANTNAME <br />PARCEL TAX I.D. # <br />2Yo�► vt o �.v( C�a� <br />TRACT <br />LLl_ �7U3 Z 35�'' �✓e ,S� %��e-./( w4. <br />� <br />CO TRACTOR <br />{�D�,�,. �,��+. ��G <br />PHONE <br />�,u�-���3-�,�� <br />PROPOSED USE OF BUILDING <br />5 �l� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />S �' \ <br />- P�uMsir <br />NO. � TYPE OF FIXTURE OF. ITEM <br />CONTACT FOR PERMIT <br />'� yln �cSS�- <br />ADDRESS <br />17b3Z 3S �l��c S� l��-II wu. <br />Building <br />PERMIT Combinati0n <br />TYPE Demolilion <br />Sprinkler <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/MOP/ETC.) <br />OTHER <br />Sign <br />� 2Z(�S <br />1 LI ZS -7'-�3 -� y l�l <br />PHONE <br />�(ZS'7�!?-1�1b' <br />Z�p CON7R. LICENSE # <br />yyc,� Z <br />J�}%14.T R C-Ld3Z C ( <br />�ddition HEATSOURCE <br />ter,,tion Electnc <br />New Gas <br />RepaidMaint. Uther <br />CI7 f OF E\�ERETT I.00AL SALES TAX CODE IS 3105 <br />NO. I TYPE OF PIXTURE 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 />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICAT�JN AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS 0'r LAWS AND ORIDINACES GOVERNING THIS TYPE OF'.VORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />fJOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE PERFORPAANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OVJNER OF THIS PROPERTY 70 PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRH'��S LAA 18.27 RCW�� 296200 WAC. ^ <br />%ri w�i %/� d� � 5 - �- 1 <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />