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SITE ADDRESS <br />/ i, 0 8 �'s ?� <br />-�. <br />,✓� �L' LOT N0. <br />�ES� r � <br />OWNER <br />P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257•8810 - FAX 425-257-8857 <br />PARCELTAXI.D.# <br />�-T- S �:�J <br />lILOCK TRACT <br />�}�IGkJ�T1 v�e00� <br />Nr� � r 7 <br />r� �..+ �s �8 /= <br />PERMIi a <br />_ -- (yaa'�3�st-yeuo <br />(��vtT �ewtt[�u��dtYLS,Snl�. D(3o /.S%�t.�tilvNowii�rl�ulA 9�'=yl — <br />TENANT NAME I CONTACT FOR P,-RMIT PHONE <br />CONTRA,CTOR <br />�.�i� <br />PMONE <br />zj-� 3.ti 3 -yaou <br />PROPOSED USE OF BUILDING <br />%� ;: Z.-� %-/C u. S c ` 0'�:� .S ��7� 1.4li <br />�S F r:l <br />AODRESS <br />/'o G on �; �y , i,����.� � SN, �H <br />Building Mechanical <br />PERMIT � Combi�ation R Plumbing <br />7YPE Demolilion p Slgn <br />Sprinkler <br />CGNTRACT PRICE OF WORH �8 65� � 00 <br />WORK DESCRIPTION <br />s F�2 � A� s; c <br />I.`U��l»�lyfi3 W:1��I:O13.5 <br />S WATER CLOSET (TOILEI) <br />2 �BATHTUB <br />.3 � LAVATORY (WASH BASIN) <br />- ! Sh+OWER <br />_� KITCHEN SINK & DISPO'iAL <br />_L_I CiSHN/ASHER <br />IL�UNDRYTRA� <br />_ r�CLO?HES WASHER <br />URINAL <br />— DRINKING FOUNTAIN <br />_(_I� FLOOR DRAIN <br />I � BACKFLOW PREVENTER <br />_; SINK �SERVICEiBAR/MOPIETC.) <br />OTHER <br />� z �(3 F� <br />TYPE <br />21G CONTR. LICENSE N <br />y'�j'y�J� �.��rrnl,f+t085-n�3 <br />�KV ii�ro/c:os <br />�AOOi4on <br />qiterauon <br />New <br />fteDainMainl. <br />NEATSOURCE <br />E�ecc : <br />Gas <br />, piner <br />CITY OF EVERETT LOCAL SALES TAX CODE IS :105 <br />NO. I TVPE OF FIXTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />= FORCED AIR SYSTEMS <br />HE. ' PUMP <br />UNIT HEATERS <br />� CLOTHES DRY[R <br />_L RANGE HOOD <br />1_ WATER HEATER <br />METAI. FIREPLACE/STOVF <br />FIREPLACE INSERT <br />I GAS FIREPLACE <br />/ GASRANGE <br />�GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />•-EREB� CERiTIFY TMAT I HAVE READ AND EXAMINEO THI$ APPUCATION AND KNOW TME SAME TO BE TRUE AND CORRECT A�'_ <br />•�iC'; iS�OkS OF LAWS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPUED WITH YJMETMER SPECIFiED rERE�,', C<i <br />...' 7nE GRANTING UF A PERMIT DOES NOT PRESUME'0 GIVE AUThORITY TO VIOLATE OR CANCEI TME PROVISION CF ahi �i�Ea <br />�.'uTE OR LOCAL IA�V REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZEJ B� '�E <br />' �+E� OF TMIS PROP RTV TO PERFORM THE WORK FOR WMICH APPLICATION IS MADE AND I COMPLY WITM THE STA'E <br />C�ORS Ln�V 27 RCW AND 296 200 WAC <br />, � \ . • /_ � <br />DE81T 8 CREDIT CARDS ARE NOT ACCEPTED <br />izJ <br />