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F�tRMIT APPLICATI�UN <br />CITY OF EVERETT PERMIT SERVICES <br />j�v�J 3200 CEDAR STREET, EVERETT, WA 98201 <br />� 425-257-8810 - FAX 425-257-8857 <br />RP � 1, ( �e 11Se �e-4ec-m�r�.��� - Re� II �p3 -or�� <br />SITE ADDRESS PARCEL TAX I.D. N P RMIT # <br />�' QR'��' ,PL SW � ) Oo�949na00050n �3 ��' "��/5 <br />LOT NO. I BLOCK �I TRACT <br />DESC. <br />N ZS <br />7��e % �e d w a y C o r p, po.l3 30 � y �v��e-��,�kt 48ab � <br />TENANTNAME I CONTACTFORPERMIT PHONE <br />Th� Treciu�a <br />CONTRACTOR <br />PHONE <br />PROPOSED USE OF BUILDING <br />✓% �Q�- <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />� � ��`r <br />I��, +1-, v`f -re c1. �.c�o v u zS 30 3-� I OO <br />ADDRESS <br />Building <br />PERMIT Combinellon <br />TYPE Demolilion <br />Sprinkler <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CL05ET (TO�LET) <br />BATHTUB <br />LAV. TORY (V'�ASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLCTHES WASH[f2 <br />URINAI <br />DRINKING FOUNTAIN <br />FLnOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/OAR/MOP/ETC.) <br />OTHER <br />Mechanical <br />Piumbin�. <br />Sign <br />ZIP CONTR. LICEN9E N <br />Addltlon HEAT SOURCE <br />WORK Alleratlon j� Eleclric <br />TYPE New 1� Ga� <br />ReDalrlMalnt. � Olher <br />C�TV OF EVERETT LOCAL SALF.S TA% CODE IS 710! <br />N0. I TYPE OF FIXNRE OR ITEM <br />A/C — A/HANDL'NG UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRVER <br />RANGEHOOD <br />WATER HEATER <br />;AETAL FIRFPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIRE?LACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY TN.4T I HAVE REAO AND E%AMWED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE O�'NORK WILL BE COMPLIED WITH WMETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF.4 PERMI7 DOES NOT PRESUAIE TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br />STATE OR LOCAL L4W RECULATiNG CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTr TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTR�CTORS LA'N 18 27 RCW AND Y96.200 WAC. <br />! �' <br />DEBIT & CRE61T CARDS ARE NOT aCCEPTED <br />��Z <br />O(c+ '01 <br />