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' SITE ADDRESS <br />� Cii G4�L6 C <br />' i_erni_� �oT <br />DFSt: � <br />r'ERMIT APPLICAI iON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8&57 <br />BLOCK <br />i 1-�� e r,u� r� L/_l' ..�v�s /�7n�'t= <br />PARCEL TAX I.D. lf�v 3N PERMIT q <br />S� /:3C�Z� 3 ��9 C��% C U�( �"�- �'"'� <br />� TENANTNAME CONTACTFOR PERMIT� � PNONE <br />-- ---���4 �.vr.wa,r-y� ,�d6 �sb -vg�d �f <br />! CONTRACTOR ADDNESS 21P CONTR LICE_�SOE�If � I <br />' � <br />t 1�i�R�ef� L � IO <br />I PHONE �,AF�CE �r.� �NF—S� .___---__—__._ ��5���� �J N`� j"1 ' <br />� PROPOSED USE OF BUILDING (� �uilAing � Mar,hanical AUAit�on HEAT SOURCE � <br />� PERMIT y�f�( Combination Plumbing WORK Alterelwn Q Eleclnc I <br />� ��D I TYPE �j Demolition , Sign ITYPE � New w r,as <br />�l U Sprinklr.r L) Repair�Maml U Other <br />� ---- -- <br />� CONTRACT PRICE OF WORK <br />�' —_____..___.__ _ —._.. __. __'_ ---_ <br />� WORK DESCRIPTION � l_�) �• ["n ����n r%_5," <br />� � �.�� <br />__._ - ---- <br />PLUMBING <br />NO I 7VPE OF FIX7URE OR ITFM <br />WAT[R CLOS[T (701LE1 � <br />DATF:TUf3 <br />L�V�TORV (WAS��I BASIN) <br />SHOWFR <br />KI7CFIEN S�MK 8 �ISPOSAI <br />DISliWASH[R <br />I.AUNDRY TR�V <br />CIOiHES WASHER <br />UIiM�L <br />DRINKMG FOUN iAIN <br />FLOUR ORI11N <br />BACKFLOW PREV[NTER <br />SINK (5[RVIC['l3nR�MOPiFTC.) <br />OTH[R _ _ <br />CITV OF EVERE7T LOCAL SALES TAX CODE IS 3705 <br />���3 <br />MECHANICRL <br />NO. I TVPE OF FIXTURE OR ITEM <br />A/C - A/HANDLING UNITS <br />_f FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />� CLOTHFS DRYER <br />�RANGE HOOD <br />WA7ER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />�GAS PIPING <br />EXHAUSiFAN <br />OTHER <br />I HERERY CERIiIfV THAT I HAVE REAQ AN, FtAAfINED THIS APPUCATION AND NNOW 7HF SAME TO BE TRUE AND CORFECT AL� � <br />PROVISIONS OF U1W5 AND ORIUINACES IiOVFRNMG THIS TYPE UF WORK WILL BE COMPLIEO WITH WMETHER SPEGFIED HEREIN OR <br />NO7 THE GRANTING OF A 1`[RAfIT f`OES NOT PREtiUM11E TO GIVE A�TFORI7V 7p VIOUIiE OR CANCEL THE PROVISION OF ANV OTHER . <br />StA7E OR LUCAL LAW REGULATIN�7 CciNSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BV THE ! <br />OWNFR ( F THIS PROPERTV TO 1'FRFnRA1 THE WORK FOR WHICH APPIICATION IS MAOE AND I COM1IPLV WITH TNE STATF <br />CONiRg�TORS LAW ig27�RCW ANj):�96.^•00 WAC � � <br />ni.:ed Ayent - �ate '�, <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED f�� � <br />