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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EV[RETT, WA 9fi201 <br />425-257-8810 - FAX 425-257-895� <br />SITE ADI � J� l.' � ��G�� — <br />�l� S�. �'� <br />LE6A LOT NO. / ^ BLOCK� <br />OESC. (�� <br />I.D. • � <br />:J <br />C�x-nC¢�K, (n1C.., I410 S�wtriSp,t�a�,sl�J�/, s-rANwenp, I,JR 9'PJZQL <br />TENAMNAME COHTACTNAME �4u\ rM PMONE <br />N/� I�jn�-G�7R.�fl9t� 33V-a1fS 534-5931. G� <br />� 310 - � VL�. <br />CONTRACTOR A�DqE88 DP COHTR.LJCEN8E1 <br />PHONE s A wE <br />PROPOSED USE OF BUILDINO <br />SQ FO 1Z D <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />p�Aa �zz3 <br />6As�� �I 9� <br />NO. � TYPE OF Fl%TURE OR RCM <br />�_ WATER CLOSET (TOILET) <br />Z_ BATHTUB <br />�_ LAVATOFY (WASH BASIN) <br />SHOWER <br />� KITCH�N SINK 6 DISPOSAI. <br />_J_ DISNWASHER <br />LAUNDIiY TFAY <br />� CLOTHF:S WASHEFi <br />_ Uf11NAL <br />___ DRINKIIJG FOUNTAIN <br />FLOOR DRAIN <br />_ BACKFLOW PREVFNT[11 <br />_ SINK (SEf1VICE/UAR/MOf'/ETC.) <br />OTIiER <br />� Bullding Mechenical <br />PEAMIT Combinetlon � PlumAing <br />TYPE Demollllon Sign <br />Sprinkler �► ol hendx� <br />NO. <br />G ��Q G l�►E 0 36 �4 <br />c�cR io/Lz/o 3 <br />Addllbn I MEAT BOURCE <br />Alleralbn Electric <br />New Oes <br />Napelr/Memt. aher <br />CITY OF EVEHETT LOCAL 8ALE8 TAX CODE IS 7f06 <br />MECHANICAL <br />TYPE OF FlIfTURE OR REM <br />n/G - IVHAN�LIN6 UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT H(:ATERS <br />CLOTHES DRY[fl <br />RANGEHOOD <br />WATEF HEATER <br />METAL FIREALACE/STOVE <br />FIREPLACE INSERT <br />OAS FIFIEPLACE <br />OAS RANaE <br />OAS PII'ING <br />FXHAUST FAN <br />OTHEfi _______ ___ <br />'.—� ----------- - <br />1 HFREBY CERITIFV THAT I HAVE Rf:AD AND fl(AMINED iHIS APPUCATION AND KNOW THI '� A1,1[ TO BF TRUF AND COfiRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES 60VERNINO THIS TYPE OF WORK WILL BE COM�LiED WITH WHETIIEq SPECIFlED HEqFM (��i <br />NOT. THE aRANTING OI' A PFRMIT DO[S NOT PRFSI IME TO 61VE AUTHORIiV TO VIOLA7[ 1/F1 CANCEL THE PROVIS�ON OF ANV OTHER <br />STATE OR LOCAL LAW RFGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTf1UCilON. TFUT I AM AUTHOR17ED BY THE <br />OWNEH TNIS PROPEPTV i0 PERf-ORM THE WORK FOR WHICH APPLICAiI(NJ IS MADE RND I COMPLV WIiH THE STATE <br />CONT CT RS LAN/,18.27 RC� AryD 2g8.Ypp VyAC <br />/1 i/ .�/1 <br />