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SITE ADDRESS <br />LOT NO. <br />i ( <br />r�Ef�MIT APPLICATIOM <br />CITY QF EVERETT PERMIT SERVIC:ES <br />32J0 CEDAR STREET, EVERETT, WA 88201 <br />425-257-8810 - FAX 425-257-8857 <br />� <br />BLQ"' <br />�a�c•rt�•J �a�r. �, _ . — <br />TENANTNAME <br />CONTRACTOq <br />CF[�cY�SvJ Cc7�. ��1� <br />PHONE , _ _ <br />PROPOSED USE OF BUILDINO <br />�S1AiiilE �/�i���/ �C.)• <br />/ <br />CONTRACT PpICE OF WORK <br />PARCEL 7AX I.O. I <br />� O 37 - <br />TRACT <br />Ru i <br />ADDRH83 <br />o � 3oas— F�� <br />ICONTACT NAME <br />ADDRE88 <br />�Po • &�c 3oas— <br />FJt <br />Bulldl�g Mechenlcal <br />PERMIT � Combinetlon R Plumbinp <br />TYPE Demolitlon p Slgn <br />Sprinkler <br />WOpKDEBFAr I{�N'r_-7�y (� A <br />�i., t o � � 1#a � <br />NL'�� <br />N0. I TYPE OF Fl%TURE OR REM <br />3 WATER CLOSET <br />Z BATHTUB <br />� LAVATORY (WASH BASIN) <br />SHOWER <br />= KITCHEN SINK 8 DISPOSAL <br />� DISHWASHER <br />LAUNDRY'TRAY <br />� CLOTHES WASHER <br />URINAL <br />_ DRINKINO FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />_ SINK (SERVICE/BARlMOP/ETC.) <br />— 0 Z � �'0//'Z C� <br />�_�_ �/CF 3� <br />—"'aP PHONE <br />$�3 �/,�s 3E6-7�/6 <br />PHONB <br />21P CONTR. UCENBE II <br />/�'a�3 6Eu�'C7o99n�c <br />Addttbn H8AT80URCE <br />WOpK Altentbn � Elac���c <br />TYPE New !.. <br />RapelNMdnL Otlsr <br />CITY OR EVBREiT LOCAL 8ALE8 TA% CODE 18 �f06 <br />�{00 J�l GA¢i9G'F' ��. <br />�Q�S <br />2i� �U <br />NO. I TYI � OF FlIfTURE QR fTEM <br />A/C — A/HANDLINO UNITS <br />FORCED AIH SYSTEM3 <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />HANQE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSER7 <br />OAS FIREPLACE <br />�AS RAN�E <br />�AS PIPINO <br />EXHAU3TFAN <br />OTHER <br />• � <br />I HEREBY CERITIFY THAT I HAVt READ AND EXAMINED THIS APPLICATION AND KNO!`! T}1: SAME TQ BE TRUE AND CORRECT. ALL <br />PROVISI�NS OF IAWS AND ORiDINACES QOVERNIN6 THIS TVPE OP WORK WILL 6� �UA�P.IED WITH WHETHER SPECIFIED HEREIN OR <br />NO7. TYc ORn`�TINO OF A PERMIT DOES NOT PRESUME TO OIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVI910N OF ANY OTHEq <br />STATE OR LOCAL � AW REGUTATiNO CnNSTRUC1�lON OR THE PEFlFORMANCE OF CONSTRUCTION. THAT � AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WNICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTfNCTORS LAyJ 1827 RC}N AND 288.200 WAC. <br />�L <br />