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SITE ADDRESS <br />2nn3 - <br />LEOA LOT NO. <br />DESC. <br />OWNER <br />aa�,« �.� <br />TENANTNAMF � <br />��ERMIT APPLICA`� ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL 7AX I.D.1 <br />I ST. _ � � � <br />BLO�K TRACT <br />5e� a3 � �-r as <br />S�z����l..c I"1U3a,-3��-�µ�v.cSE � <br />CONTRACTOR � ' <br />=-d c�4 �R E�R-(�Ri9rS l.L..0 <br />PHONE � <br />PROP09E0 U8E OF BUILDINO <br />5�-v-� Fa,wa.� <br />CONTHACT PRICE OF WORN <br />nunR YCOl:H1Y710N <br />NO. I TYPE OF FIXTURE OR REM <br />wnl tY GLOSET <br />BATHTUB <br />LAVATOR� (WA^uH BASIN) <br />SHOWER <br />KITCHEN SINK.d DISPUSAL <br />DISHWASIiER <br />LAUNDRV TRAY <br />CL07HES WASHER <br />URINAL <br />DRINKIN6 FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PFEVEN7ER <br />SINK (SERVICE/BAWMOP/ETC.) <br />OTHER _ _ <br />CONTACTNAME <br />�� �CS`JI`�'1 <br />ADDqE93 <br />i'1�3a - dStiA vr Sc <br />Building III��� Mechanical <br />PERMIT ombinallon I�Plumbing <br />7YPE Demolilion � Sign <br />Sp�inkler <br />� <br />�. yas-�a3-���A <br />PHONE <br />4�s-���3-i�18 <br />ZIP CONTR. IICENBE • <br />9�do,�. Aoat�i���3a�i <br />AddObn HEAT 80URCE <br />WQRK Alteralwn n Elettrk <br />TYPE �New Z (iae <br />Repelr/Melnt. L/ OIMr <br />CITY OF EVENETT LO�' iC SALEB TAX CODE 18 �106 <br />NO. � TVPE OF FlIfTURE OR REM <br />A/(.: - A/HANDLINO UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANOEHOOD <br />WATI:R HEATER <br />MFTnL FIREPLACE/STOVE <br />FIREPLACEINSERT <br />6AS I-1Rc'PLACE <br />OAS RANOE <br />GAS PIPIN6 <br />E%HAUSTFAN <br />OTHER _ <br />1 HEREBV CERI?IFV THAT I HAVE REA6 AND FXAMINED TFIIS APPLICATION AND KNOW THE SAME TO BE TRUE AN� CORRECT ALL <br />PROVISIJNS OF LAWS AND ORIDINACE.S 60VERNINO THIS �VPE OF WORH WILL BF COMPLIEU WITH WHETHER SPECIFIED HEiiE1N OR <br />NO7 THE ORANTING OF A PERMIT DOES NJi � RESUME TO O�VE AIITNORITV TO VIOLATE OR CANCEL THE 1'IiOVISiON OF ANV OTMEfi <br />STATE OR LOCAL LAW REGULATING CONSTRUCTI(�N Oii Th!E PERFORMANCE OF CONSTRI'CTION TNF* I AM AUTHORIIED BY TNE <br />OWNER OF iHIS PROPFRTI' TO PEHFORM THE WORK FOR WHICH APPLICATION I� MADE AND I COMPLY Y��TH T.iE �TATE <br />CONTRACTORS LAW iB27 RCW AND 2962W WAC <br />( <br />