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�, <br />--.-- <br />, <br />PE�MIT <br />APPLICATIO <br />C17Y OF FVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />� .,�y-1 �. <br />425-257-8810 — FAX 425-257-8857 <br />/,' ' / : (, �,S <br />SITE AUDFESS <br />I [?� �#7 <br />LEGh I.OT N� I BIOCK <br />DESC. 'Fl <br />JIVNEA <br />�� � <br />�_�.11(n r � �-� (� ,�1F. S .1 N � . <br />TENANT t1A61E I <br />CONTRACTOF ^� <br />�'%'CG��� �—�(�✓�P� <br />PARCEL TAX I.C. N PERMR a <br />. <br />>� � '�� >i2�33 <br />(,_ � ? I �a'1 ��Lal C�CJ � <br />TRACT <br />` l;. JA.�:e <br />CONTACT NAME I � . <br />�k-F �i'�G U�-i <br />ADORESS <br />�.� � <br />IUU� �ZC� <br />�c�� �lL <br />ZIP <br />`i/,)^ L55 u,iuu <br />PH��NE <br />��� ZS � v�, <br />CONTR. UCENSE M <br />IPHONE ��� S A ti^ C /a � A(o vG <br />I �CGrH,'9Xd�� <br />I PROPOSEO USE OF BUILDING Buildmg MeChanical Addition MEAT SOURCE <br />i � � PEHMIT Combina!io�i R�j Plumbing WORK Altnrntwn R Eiectr�c <br />� ��- �� ` 7YPE DPmolilion U Sl�n h'PE �Ne� p� Gss <br />S nnkler Ro alrlhtaint. I.J Ou�ar <br />COhTRACT PRICE OF WORK � Z ULJ�� � CRY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />,' 1•lORK OESCR1FTi0N <br />i <br />� � � .� �y � �F�� <br />��. A �� � � �' <br />�C1S� �� ��(�U . <br />� �IO. I TYFE OF Fl7CTURE OR REtA <br />�WATER CLOSET <br />BATHTUB <br />. -ti LAVATORY (WASH BASINj <br />SHOWER <br />I KiTC•HEtJ SINK 8 DISPOSAL <br />, � DISHNiASHER <br />�' � �.AUNDAY TRAY <br />i i CLOTHES'."/ASHER <br />I_ URINAL <br />i _ DP.INKING FOUNTAIN <br />fL00R DRAIN <br />� BACKFLOV! PREVEN'fER <br />I = SINK (SERVICElBARRdOP/ETC.) <br />OTHER <br />NO. I TYPE OF FURURE OR REM <br />A!C - A/HAPlDLING UNITS <br />fORCED AIR SYSTEMS <br />HEAT PUMP • <br />UNIT HEATERS <br />CI.OTHES DRYFR <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPIACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I:1ERE8'/ CEi11TIF'! THAT I HAVE READ AtJD E%.AlAINED TNIS APPLICATION AND KNOW THE SAME TO BE TRUE hND CORRECT. ALL <br />�ROVIS�G'7S OF LFYlS AND ORIDRIAGL.S GOVERNING THIS N4E GF PlORK WILL 8E COIAPLI[D WITH WHETHER SPEGFIED HEREIN OR <br />'iOT THE GRANTING OF A FERIAIT OOES NOT PRESUTAE TO GIVE AUTHOqITY TO VIOLATE OR CANCEL THE PROl9S10N OF ANY OTHER <br />SiA7E OFi LOCAL LAV! REGULATItlG COtJSTRUCTION OR TNE PERFORfAANCE OF COIdSI'RUCTION. THAT I A�d �UTHORIZED BY THE <br />O`NNER OF ih11S PROPERTY TO PERFGR�d THE `lJORK FCR WHICH APPLICATION IS MADE AND I COIdPLY WITH THE STAT[ <br />CONTRACTOASLAW1827RGWAN029Ei200VlQC.-- . / <br />l`/��/J1 <br />�Iz <br />