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PtRMIT APPLI�CATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 922G1 <br />4�5-257-8810 — FAX 425-257-8857 <br />UN-I � -��--- <br />j�,w ,s seA <br />SIT[ ADDR�55- ----�--- �---------- PARCEL TAX I.D. � ----- 'I ��ER�.�.T a ------.. . <br />/S; .) �J5-TN s � - S;ti� --1- ��1�---�--'�- <br />.. ..: LOT NO LLOfK TI<ACT <br />"�' QotGc<sm ��`000.s <br />GYINER� I7DRESS ZIP F�HON� <br />n cy+-5 3>�-�,eu� <br />ivlT �/CwItLiG��JtYLs,-.i�ll �llo��/S7 .��lnN�����r1 t,��f' k'�yl <br />` �� '—�---- _ <br />iLNANT NAME I CUn:"ACT FOR PERMIT PHUNE <br />�ONTRACTOR <br />r,:l � <br />PIIONE <br />(.i��"� 35 3 y���o <br />PROPOSEO USE OF BUILDING <br />��,:i...� ��4�'wf� (JA.�Sri� <br />/S r" r:1 <br />ADDRESS ZIP CONTR. L��,FNSE o <br />�'OGoXi.s-7ti,1�ur��m�sN,�.JH ��'Z9/ Gmr"n/i�rJdS-n�3 <br />PERMIT <br />NPE <br />CGNTRACTPRICE(�F:�ORK �EGj���^UO <br />':�JRK �ESCRIPTION <br />C,�V i�l=,/c:rs <br />j� Building I-"1 MechOnical I� AOOnion HEAT SOURCE <br />ISh Combinaticn �__� Plumbing WORK �rJ Allerauon n E e:� : <br />�Demolition LJ Sign TYPE �� New � Ga< <br />Spnnklef (J ReDa�rlMan� L� Ot^e� <br />CITY OF EVERETT LOCAL SALES TFJf CODE IS 7105 <br />� F �', �n � A <br />s � c� �' z-y � <br />NO TYPE OF FI%TURE OR ITEM <br />�T�:ATER CLOSET (TOILET) <br />L HAiHTUB <br />3 _AVATORY (VVASH BASIN) <br />� �r�pWER <br />�� - « iTCHEN SiNK 8 D�SPOSAL <br />� .:�"i��lh'ASHER <br />. :�l!NDRY TRAY <br />� . �-'1ttES N'ASHFIt <br />— �iINFL <br />— _'tiiNKING FOUNTAiN <br />_L r"LOOR DRA�N <br />I '�, BACKF�OW PREVENTER <br />_; SWK �SERViCE�BARMOP�ETC ) <br />�7HER <br />NO. I NPE OF FIXTURE OR IfEM <br />` A/C - A/HANDLING UNITS <br />� FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />� CLOTHES DR1ER <br />_(_ RANGE HOOD <br />1_ N'ATER HEP.TER <br />METAL FIREPLACf:�STOVE <br />FIRFpLACE INSERI <br />� GAS FIF�PLACE <br />% G�.S RANGE <br />��AS PI.ING <br />EXHAUSTFAN <br />__j OTNER ___ <br />�EREB� CERiTIFv TMA71 HAb'E RLAD AN[7 EkAA1WEC I"NIS APPLICATION AND KNO�V TME S��dE TO OF i RUE ��ND CORREC' �L. <br />:-RO`: iS��CNS U% LA\NS AND ORIDiNACES GOVERNING TM�S TYPE OP WORK IVi�L BE COAIPLIED 4�'li�. �NHETHER SPECIFIED nEREh C� <br />.. '^E ���'ANT�NG OF A pERMIT �OES NOT PFFSUAIE TO GIVE AUTHORITV TO V�GLATE OR ('.�NCEi 'htE � RGV�5�0�� OF Ar.�, 0'^E= <br />�._�:4 ,.nCAL Li.W REGULATING CONSTRUI"TION OH TME PEftFORMANCE OF CONSTRUCIOk THA7 �.1LI P„ThOR�LE-; B� ': <br />.'. •,i: �� �� '���5 NROPERTV TO PERFORh1 7NE 1'�ORh FOR IYMCM APPLICATIUN i$ IdApE AND � C01'?L� �,1i1 n'n"c 5'A'"c <br />'<9 �/u1 7 RCVV ANO 29d :00 YVAC <br />V � <br />�� 12 •` /L�3J 03 <br />i- <br />� �f �_� rerCi�nlraClGr.r�.Ih�nZeC Agenf Dale <br />1 <br />DEBIT 8 CREDIT CARDS AR5 NOT ACCEPTED �Z <br />