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� <br />'� SITE ADDRESS <br />//G3 <br />' �I'GAL LOT NO <br />!�r5c /2 <br />r'ERMIT APPLICAI �ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAl( I.O. It �L � I PERMI7 a � <br />S�, SC�� �P�-y.1�Q.��� �� 1__—c�'�i� � �- ?• <br />�BLOCK TRACT /// T <br />�.en. �•a�►s �-„ar�r..��5 C ldv�lv ✓,Ci��G <br />.�YDSJ1��' = 5.1�_1�� ��rr.b ��%� 9�� '' 7 S-y da3a . <br />� i EN� NT NAME CONTACT FOR PERMI�� PMONE � <br />� —�r�E'E4 La�tia,cy,e �3�� �sa-v v�' �f _ ,I <br />ICONTRACTOR AODRESS ZIP �X�02N�SLICE_I�S;�IQ� � <br />� j�0 � <br />PFiONE .. �Ai'�� �g �N►=S� __ __— � �STI 1 �. !� 0 � / " � � <br />i PROPOSED USE OF BUILOING �udding L� Mar.henic3l Atldlllon HEAT SOUNCE � <br />PERMIT Combinalion �R{X Plumbin WORK LR( Altaratbn G Elednc ', <br />I ���I TVPE � Demolition U Sign y TYPE 6 New w Gas i <br />r�- Sp�inklf�r RepaiUMaint L� Other <br />CONTRAI;T PRICE OF WORK <br />i WORK DESCRIPTION / `Q <br />, /l.� C(� �J7 /�" <br />PLUMBING <br />NO TVPE OF FIXTURE OR ITEM <br />�WATER CLOS[T (lOILETI <br />E3ATIiTU[3 <br />'� I AVATORY (WASH BASIN) <br />SHOWfR <br />T KITCHEN SINK 8 DISPOSAL <br />i DISHW�SHER <br />� LAUNDRYTRAV <br />/ CLOTHFS WASHFR <br />URWM <br />ORINKING I'OUNTAIN <br />FLOOR URAIN <br />� BACKFLOW FRFVF.NT[R <br />SINK (SERVICE/BAR/MOPIETC � <br />OTHER <br />�__—_—:�/'_. ____ <br />�7� L�U��- <br />CITV OF EVERETT LOCAL SALEB TAX COOE IS 310! <br />�� � <br />MECHANICAL <br />NO I TVPE OF FI%TURE OR ITEM j <br />_� <br />� <br />A/C - NHANDLING UNITS <br />FORCED AIR SYSTtMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGFHOOD <br />W�TFR HFATER <br />METAL FIREPLACE�STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS P�PING <br />FhIiAUST FAN <br />i HEREI3v CFRITIFv THAT i HAVF RFAU ANU EXAMWEU iHIF APt�LiC�TiON AND HNOW THE SnME TO BE TRUE AND rpRRECT ALL � <br />PRUVISIONS OF LAWS AND O(iIUINACES GOVERNWG THIS T�PE OF �VI)RK WILL BE COMP�IED WITH WHETHER SPECIFIED HEREIN OR '� <br />NOT THE GRANTING UF A PElUd1T UUES NUT PRESU�fE TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE PROVISION OP AN`! OTHER <br />S7ATE OR LUCAL LAW RE�UUITING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWN[R OF zHIS PRpPERTV TO PFRFORM THE WORK FOR WHICH APPLICA710N IS MADE AND I COMPLV WITH THE STATE <br />CONTRAC�7'ORS LAW 18 2 C�AND 296 2U0 WAC <br />�/,.t... �� �.�� /o�v�3 <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED I�� <br />