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r�ERMIT APPLICA'� iON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS �� PARCEL TA%I.D. N-�L��� P�RMiT a <br />11.��'__91__ ����L�J -1—�':�y 1 �,5s r�� o >� <br />�F��AL L07N0 BLOCK TRAf,T /'/ <br />nesc � G— _�_�� C•P.fi.EK �AlL�6N5 \hlo� <br />-�-- —'° � <br />OWNF.R ODRESS tIP PHON <br />TENANT NAME CONTACT FOR PERMIT' ' PHONE <br />---- --------- —��'�-� � Nr�ua�:,e 3��:' '�h-u�� �� <br />CONTRACTOR ADORESS ZIP GONT0. LICE./�SUE��� <br />tX{aQ�.`� liI0 <br />PHONE jA�� �g ��\ �� ' J{�.STf�F /�(1 H`� H <br />�'� L.�,U <br />PROPOSED USE OF BUILDING <br />S �� - <br />CONTRACT PRICE OF WORN <br />f3wldiny Mer,hanical <br />PERMIT � Combinalion � Plumbing <br />7YPE Demolition Sign <br />Spnnkler <br />� WORN DESCHIPTION /�/ /�� II )_./ / <br />/VC-LV ✓� �7� <br />- ------ -- <br />I PLUMBWG <br />ii/�xflifl"ii�1:7��7:�liy :I <br />WNERCW.9Ei11011.�=1) -- <br />OAl FI � Uf3 <br />L/1VAiORY (WASH BASIN) <br />SHOWFR <br />KIl'CH[N SINk 8 DISf'OSAI- <br />DISHW�SHER <br />ILAUNDRY7RAV <br />CI.OTH[S WASHFR <br />URW�L <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (Sf_RVICE'f3ARiMOP�E7C.) <br />OTHER <br />, <br />�AAAlllon I HEAT SOURCE <br />AlteraBon Elecinc <br />New Gas <br />L� ReneinMainl Olhe� <br />CITY OF EVERETT LOCAL SALES TA7( COOE IS 7105 <br />a��7 <br />N0. I t�^E OF FIXTURE ON ITEM <br />A/C - A.NANGLING UNITS <br />__ /_ FORCE�J AiR SYS7EM5 <br />_ _ HEAT nUMP <br />UN�T HEATERS <br />1 CLOiHES DRVER <br />�Rl�NGF HOOD <br />VJATER HEATER <br />_ METAL FIREPLACE/STOVE <br />' FIREPIACE INSERT <br />I GAS FIREPLACE <br />_� GAS RANGE <br />,� GAS PIf'ING <br />� EXHAUST FAN <br />_ 01NER _ <br />' HFREf3V CERITIFV TNAT I HAVE RFAO AND EtAMINED iH15 APPUCATIUN AND NNOW'HE SAME TO BE TRUE AND CORRECT ALL <br />i'It�1VI.SIONS OF lAWS AND URIDINACFS GOVFRNIN�3 THIS TVPE OF WURK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />ru R THE GR4NTWii Uf A P[R�11T DUES NOT �RESJMF TO GIVE AUtHORITV ip VIOLATE OR CANCEL TNE PROV:SION OF A�rv OTHEF <br />ti fATE OR LOCAL f.AW RCGVIATING CONSTRUC710� OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEU BV 'HE <br />UWNFR OF T�iIS 1'ROPFRTV Tq PERFOR61 THE WCRH FOR WHICH APPLICATION IS MADE AND I COMPL� W�TN THE STATE <br />CfiNTRAC S LAW �8 " R/CW 4ND 296 200.WAC � <br />%�(�.c[Cr /�.�.� , a � �/! �. /i, �.7 5 �� <br />aiynnryrvuiy neuwnuauuunuvii.�u.c��..ynin �am <br />� 1I� , <br />I DEBIT 8 CREDIT CARDS ARE NOT ACCEPT[D `' <br />------- . _. _-- -- — - ---� <br />