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� <br />�� <br />P�9MIT APPLICATICV <br />CITY OF EVFRETT t�ERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />I siTe aooaess _ <br />G "' <br />� �� � � �� � � , . <br />LEGA LOT N0. �LOCK <br />DESC. �' <br />OWNEF <br />� ' �J'if:/ /� �, <br />�—.� � <br />TENANT NAME <br />CONTHACTOR <br />, �. <br />� � �� � <br />PMONE <br />� �_ _ <br />� PROPOSED USE OF 9UILDING <br />� <br />` t r <br />CONTRACT PPICE OF WORK <br />WC1RN DESCRI; fION <br />� ; � / . . ,�( .. �I/��� <br />.%. <br />NO. TVPE OF FI%TUFE OR ITEM <br />�_ WAT[R CLOSET <br />' F3ATHTUB <br />�` LAVATOqV (WASH BASIN) <br />SHOWEF <br />,L KITCHk�N SINK d DISPOSAL. <br />_L, DISHWASHEF <br />-- LAUNDRY TRAY <br />_L CLUTHES WASHER <br />= U�7MAL <br />-- DRINKING FOUNTAIN <br />FLOOR pfiAlN <br />_ BACKFLOW PF[VENTER <br />_ SINK (SEPVICE/BAR/MOP;ETC ) <br />— OTHEI� <br />PARCEL TAX I.D.1 <br />/ / ` ��// <br />(,(� j ��. � - ll. �'/P. <br />TRACT � <br />�;� /�, �;'�� ¢��>K <br />ADDRESS , np <br />i r' /c . � i.:� ;/r Il ' /.�; / <br />i . / .<.. �✓/i ��/_, . . <br />i�, <br />ADORESS <br />r' <br />� <br />,. ' <br />RERMIT 1 <br />L��.����� L�-�� <br />NAME PHOHE <br />� i-���, .. �. ,. , , , <br />Bwld�ng Hlachanical <br />PERMIT � Combinalion � Plumbing <br />TYPE Demolilion Sign <br />Sprinkler <br />21P CONTR. UCENSE M <br />l / �--,'ii {� /�i (. e <br />Adtliton <br />�RK Allera0on <br />PE New <br />Repaidldain� <br />.�' /f <br />HEAT"uOURCE <br />�Electrrc <br />Ges <br />Olher <br />CITY OF EVERETT LOCAL SALES TA% COOE IS 3105 <br />' NO. I TYPE OF FU(TURE OR ITEM <br />�' A/C – A/HANDIING UNiTS <br />� FORCED AIR SYSTEMS <br />HEAT PUMF <br />- UNIT HEATERS <br />� CL'JTHES �RVEF <br />L_ RANGEHOOD <br />.1_ WATER HEATER <br />� METAL FIREPLACE/STOVE <br />_ FlFEPLACEINSEFT <br />_.L GAS �IREPLACE <br />_L,_ GAS RANGE <br />_� (iAS PIPING <br />' %�� ElCH4UST FAN <br />_ OTHFF <br />1 HEA[BV CEFIi1FY THA71 HAVE READ AND E%AMINED fHIS APPLICATION AND KNOW THE SAME TO BE TRUE ANO COfiRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS iVPE OF WORK WILL BE COMPLIED V.ITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GI7ANTING OF A PERMIT 00[S NOT PRESUME TO GWE AUTMORITV TO VIOLATE OR CANCEL THE PFOVISIf�N OF AN'I OTHER <br />STATE Oii IOCAI LAW REGULATING CONSTRUCTION OR THE PERFOPAIANCE OF CONSTPUCTION THAT I e.�d AUTHORIZED BV THE <br />OWNER OF TN�S PHOPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMf'LV WITH THE STATE <br />CONTRA,f,TORS LAW�1p 27 RC'N AND286200 WAC <br />j i � � <br />� . �� . i .L ( . � � <br />��Z <br />