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SITE ADDRESS <br />1l2Z 4S� S <br />LEGAL LOT NO. <br />�ES�. 5 <br />p'ERMIT APPLICATION �"M' "S'a � <br />CITY OF EVERETT PERMIT SERVICES � <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 — FAX 425-257-8857 � <br />I PARCEL TAl( I.D. # I PERMiT a I <br />(ivlT �Ow1tL�ui�d <br />TENANTNAME <br />� _ <br />, CONTRACTOR <br />C,�ls <br />PHONE <br />(c{LS') 35 3 -9000 <br />_ 5;,�► <br />BLOCK TRACT <br />i�uG uJ,-ri L�-� oopS <br />-rn1 � . /% G� u,r /S'7 <br />I CONTACT fOR PERMIT <br />I co3�a- �v <br />ZIP PHON <br />(yu�3s.-��euo � <br />i��1� uJA �j �'zh i <br />PHONE <br />ADDRE, S ZIP CONTR. UCE�i1E p I <br />�0 G o�( /y`7� � S�NO/�v�11 SN� u1H y'�'Zc�� cmrrnl� .• Od5'M 3, <br />C,C� I1�2J�L:oS ,I <br />PROPOSED USE OF BUILDING Building MOChaniCa� <br />PERMIT Combination Plumbing <br />� ti`�,�; �.�5 ��oxJ S�7' ��C� 7ypE Demolilion Sign <br />� �S � - �� Sprinkler <br />�I CONTRACT PRICE OF WORK �( 6� � �Q <br />�' WORK DESCRIPTION <br />SF� �/�s�c ZZ �i� <br />NO. I TYPE OF FIXTURE OR ITEM <br />,3� WATER CLOSET (TOILET) <br />2 BPTHTLB <br />�_ LAVATORY (WA:�H BASIN) <br />SHOWER <br />� KITCHEN SINK & DISPOSAL <br />_f_ DISHWASHER <br />LAUNDRY TRAY <br />1_ CLOTHES WASHER <br />� URiNAL <br />DRINKING FOUNTAIN <br />L FLOOR DRAIN <br />_ BACKFLOW PREVEN7ER <br />_ SINK (SER'JICE/BAR/MOPiETC.) <br />i;THER <br />�Addi�ion HEAT SOURCE <br />Altera�ion � Electnc <br />New Gas <br />ReDaitlM1taint. Other <br />CITY OF EVERETT LOCAL SALES TAX COOE IS J705 <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/l: —A/HAIVULIIVl9 UNI I J <br />� FORCE� AIR SYSTEMS <br />HEATPUMP <br />UNIT HEATERS <br />� CLOTHES DRYER <br />L_ RANGE H000 <br />�_ WATERHEATER <br />— METAL FIREPLACE/STOVE <br />� FIREPLACEINSERT <br />J_ GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />�� HEREBV i,ERITIFV THAT I HAVE READ AND EX4MINED THIS APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIED WITH 1'VHETHER SPECIFIED MEREIN OR <br />F:0 i TME GRANTINfi OF A PERM1IIT DOES NOT PR'cSUME TO GIVE AUTHORIN TO VIOLATE OR CAVCEL THE PROVISION OP ANY OTNER <br />STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION ThAT I AM AUTHURIZED BV THE <br />�.�'NNER OF TNIS PROPER7Y TO PEPFORM THE WOftK FOR WMICH APPUCATION IS MADE AND I COMPLY WITH THE STATE <br />CON7�ACTORS LAW 8.27 RCW AND 2962001YAC. <br />/. � �. /_ _ � <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />