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SITE ADDRESS <br />�� 7�75 - <br />LEGAL—� LOT Np. <br />DESC.� ,-, !v <br />ncQ a� (2� � <br />TENANT NAI.1E <br />`rERMIT APPLICATION <br />CITI' OF EVEFcETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />� 11'�lll-�� � . I ,�' <br />� BLOCK TRACT <br />PARCEL TNC I.D. # <br />e���i- �oa-�.�<�a-�=� ��� <br />, <br />`�C !� //%3 <br />1,-�--�- l'10�3-''a5����51- 't�Jo�'1Q 4`6012- �-las-7�{3�171', <br />i CO TRACTQR <br />�'l �..�-z., �a�.�,�u�s �, �� � <br />I PHONE <br />PF,OPOSED USE OF BU�LDING <br />S � v��\� F�w,,..si,� <br />CONTRACT PRICE OF WORK <br />r�vnrc ut�c;nir iioN <br />LeT���,L�e� ler�\ <br />v <br />CONTACT FOR PERMIT <br />�—�� G-��51 <br />A�DRESS <br />�?o3a -3'�'���eSE <br />Building �`� echanical <br />PERMIT �Combination I:a-Plumbing <br />1YPE Dem0lifiOn C} Sign <br />Sprinkler <br />PHONE <br />�l2-���-�3-«ig <br />ZIP CONTR. LICENSE # <br />i.�io�-�qfsoi� t�0(dLRr�o3aL <br />Addition <br />WORK. Alteration <br />TYPE w <br />RepairlMaint. <br />HEATS.^URCc <br />Electric <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J'105 <br />'V...�l+�l 'S-R-�-�� .r��9s�c�a.�.a . <br />iL��..�`� ��7" <br />.� <br />N0. � NPE OF FIXTURE OR ITEM <br />VVATER CLOSET (TOILET) <br />BATrITUB <br />LAVATORY (WASH BASIN) <br />SHO�NER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRItvKING FOUNTAIN <br />FLOGR DRAIN <br />BACKFLOW PREVENTER <br />SWIC (SERVICElBAWp;OP/ETC.) <br />UTHER _ <br />NO. � TYpE OF FIXTURE OR ITEM <br />A/G - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTF{ES DRYER <br />RANGE HOOD �11�L�Cc, <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE IN�ERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THA71 HAVE FEiiD AND E.YA6IINED THIS APPL'CATION AND KNOW THE SAME TO 8E TRUE AhD CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDWACES GOVERNING THIS TYPE OF WORK WILL dE COM11P�IED WITH WHETHER SPECIFIED NcREIN OR <br />NOT. THE-GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE 4UTIi0RITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE PERrORMANC`e OF COhSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WNICF APPLICATION IS MF�E P.ND I COMPLY WITH THe STATE <br />CONTFb�CTORS LA1N � 827 RGvV AND 2Ge2oa war. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />