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--- --� — (AN, Y y S--- <br /> PtRMIT APPLICATiON ��N�J/�j, �i <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREEI', EVERETT, WA 9&201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> SITE ACDRESS PARCEL TAX I.D. # � FERM!� a� <br /> —2 z � � ,��:� �E �t1 Co,� �� _ v� . <br /> __.. LOTNO. BLOCK TRACT <br /> �� <br /> �_sc � cj ��Gus,->{ L•� oupy <br /> 015'NER DDRESS ZIP PHON <br /> (yz.��35� -��oao <br /> ` ivlT '��w1tGi�t � � �c:YLS � Sn1 � . Pc� Qo,Y�S7y , �I�lID/S�uwl/Jfl{ GI�A �d�=`� l <br /> TENANT NAME CONTACT FOR PFRh11T PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR �ICENSE 8 <br /> �,.i T �o G ox �.�7y ; S�u��..� r sN, u1H 9.�'zqi c..�rr�l� ;c o 8s� 3 <br /> PHONE <br /> J?�-� 3.i 3 - 9�ou �KP ��/Lo/c,�s <br /> PROPOSED USE OF BUILDING 8uilding (� MeChaniCal Addition HEAT SOURCE <br /> PERMIT � Combination E� Plumbing \NORK � AlleraUon n E:=_v� <br /> f�;7,� �C�..s. �Jx)S�%C�K'!�' TYpE Demolilion LJ Sign Tl'PE New � Gas <br /> �S r-�`, Sprinkler RepainMa�nt. � O�rer <br /> CONTRACT PRICE OF WORK � �S��,�Q CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCR.IPTION <br /> SF�'� ��s � c' �z � 3 h <br /> PLUMBING MECHANICAL <br /> t�Q I TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br /> 3 i �;VATER CLOSET (TOILET) � AIC–A/HAI.DLING UNITS <br /> L BATHTUB 1 FORCED AIR SYSTE�4S <br /> 3 I �AVATORY ('NASH BASIN) HEAT PUMP <br /> I SHOWER UNITHEATERS <br /> � KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> �I L'iSHN'ASHER _L RANGE HOOD �, <br /> ^ !.AUNDRY TRAY 1_ WATER HEATER I <br /> _7 � CLOTHES N'ASHER _ MEC4L FIREPL4CElSTOVE I <br /> — j URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN ! GAS FIREPLACE <br /> _LI FLOOR DRAIN ! GAS RANGE I <br /> ! 9ACKFLOW PREVENTER � GAS PIPING � <br /> SINK (SERVICElBAR/MOP/ETC.) � EXHAUST FAN <br /> OTHER OTHEF2 <br />, _ <br /> —I — <br /> ^.Er'tE9Y C"cRITIFY THAT I HAVE READ AND EKAMINED THIS APPLICATION AIJD KNOW iHE SAME TO 9E TRUE nND CORF.ECT. AL' <br /> PRO'✓ISIONS OF LAWS AND ORIDINACES�OVERNIfJG THIS TYPE OF WORK WILL BE COMPLIED WITH�VHETHER SPECIFIcD HERcCa On <br /> ',0' Tn'c GRANTING OF A PERMIT DOES NOT PRESUME TO GIV'c AUTHORITY TO VIO�ATE OR CANCEL THE PROVISION OF%.NF 0'�^�K <br /> T�Te OR LOCAL�VJ REGULATING CONSTRUCTION OR THE PERFORMANCE OF CGNSTRUCTION. TNAT I A61 AUTHCR:ZEO B� 'r�c <br /> :;:IvcR OF TNIS PROP RTY TO PERFORPd THE WORK FOR 4VHICH APPLICr".TION IS 61ADE AND I CCf.1PLY',�ITh Tric ST:.Sc <br /> �_JNT . - ',ORS LAIN 27 RCW AND 296.?00 W�.G. <br /> ,_�_ , /L/3J 03 <br /> S cnawia oi wnedContractorlActhorized Agent Date <br /> DEBIT & CREDi7 CARDS ARE NOT ACCEPTED _ j�v <br />