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+ 'ERMIT APPLiCA" ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />i 425•257-8810 - FAX 425-257-8857 �y � <br />� --- r/v✓ /�1J bZo7- O <br />I SITE ADDRESS � / PARCEL TAX I.D. M PERMIT u . <br />���g' � ��Sr,� _f,�� S3S`i- �'0�-�18 voc�/ Co3ar-oo8' ; <br />LOT NO. <br />� <br />TENANT NAME <br />BLOCK n <br />l. �� i=l <br />� <br />CONTRACTOR <br />W. G. T�✓d�., Cnti1�'M. 7%�_ <br />PHONE <br />PHOPOSEO 11SE OF BUILDIN6 <br />CONTRACT PRICE OF WORK <br />�/,�,a �/5�t�� <br />2T�1 ��� <br />CONTACT NAME ' <br />N/f � 1 � ^C/lft+, <br />ADDRES � <br />z�ii i3f'��l 1u <br />�-,' Ml�l�tnud �� <br />uilding Mechanical <br />PERMIT Combinelion � P!umbing <br />TYPE Demolilion Sign <br />Sprinkler <br />/ /� S� <br />'� 3 <br />o✓ ("Yi r� Jy2 F�Y�' � <br />a,,e �u> > <br />PHONE �. �/tf �j <br />�/ylt) �1�•,��5 %'jtZ�d /p • <br />21P CONTR. LICt'NSE N <br />/✓<,TN!- c .X ol S� n/ <br />9��� 7 <br />�Oddilion <br />Allereuon <br />New <br />RepeNfdeint. <br />MEATSOURCE <br />�Electnc <br />Ges <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION /�,f �'�, �lYO S' �' �'�� � � <br />��ii...,�/ /� 757� s�-? �-r�'1` �' <br />N0. I TVPE OF FI%TURE OR ITEh1 <br />j WATER CLOSET � <br />BATHTUB <br />I LAV4TORY (WASH BASIN) , <br />SHOWER <br />, � KITCHEN SINK d DISPOSAL <br />IL DISHWASHER <br />LAUNDRYTRAY <br />' � CLOTHES WASHER <br />' URINAL <br />I DRINKING FOUNTAIN <br />' FLOOF URAIN <br />__. BACKFLOW PREVENTER <br />_ SMK �SERViCE.BAFUMOP�ETC.J <br />OTHER <br />��� � <br />/ y � <br />� �y' <br />22b <br />� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - NHANDLING UNITS <br />—Z FORCED Alfi SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />2 CLOTHES DRYER <br />Z RANGEHOOD <br />�WATERF'.EATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />� CAS FIREPLACE � <br />GAS RANGE <br />GAS PIPING <br />� EXHAUSTFAN /i// <br />OTriER <br />�, <br />I HEPEBV CERI7IFY `HAr � HAVE REAp AND EkA1dINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LpWS AND OFIDINACES GOVEFNING THIS TVPE OF WORN WILL BE COMPLIED WITH WHETN[R SPECIFIED NEREIN OR <br />NOT THE GRAMTIPIG OF A PERMIT p0E5 NOT PRESUME TO GIVE AUTHGFITV TO VIOIATE OR CANCEL THE PfiOV1510N OF ANV OTHER <br />SiATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PGRFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BV THE <br />OVlNER OF THIS PPqpERT`/ TO PEFFORM THE WOR!( FOP NJHICM APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />GONI'RACTORS LAW,i`.27 RC'N AND 296 200 WAC <br />�/ s �.� 3 <br />