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� ERMIT APPLICATrJN �""`'�ZZZs <br /> CITY OF EVERETT PERMIT SERVICES <br /> �200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425•257-8857 <br /> J�`� pc. ? d ia - aal <br /> SITE ADOfiESS FARCEL TAX I.D.N PEPMIT N <br /> floxx �o'�TM Sr, 5E. 3 af 14 -ol - S ��/oZ " <br /> LE6A LUT�Nj0. BLOCK TRACT <br /> QESC. �7 �- S T SU P J� 10►J C IZ��-�S-O( <br /> OWNER ADORESS Z1P PHONE <br /> UFZs �C tlarncsl Corasr- y��-� t,�.ccsar,e., ►zn. 3�,n-(oSz-19�� <br /> � r�►�.. 5-r�w w m� uJ 4 �i$29Z <br /> TENANT NAME I COHTACT NAME PHONE <br /> Sw� A•a��ee,-�s 'f ZS�- �sy-1993 <br /> Tw� �isttt�(SRE� '-f zS- �.Stl -1393 <br /> CON'�RACTOR ADDRE89 Z1P COMq.L10EN9E� <br /> v�s�,� tla,�,� � c��sr,$N�, 4�� c��� Rc. U,�s�+��y4 Kr <br /> PHONE .�NWp-p� WA 9�Z�{Z <br /> 3(.0- tnS Z.- 9 S � <br /> PHOPOSED USE OF BUIL�INO Building I") Mechanicel Addinon NEAT 90URCE <br /> PERMIT Combinatlon F_� Plumbing WORK Alterauon �n{ Elxtr�c <br /> C riPE Demotillon Ll Sign TYPE New .�S( Oee <br /> J� Sprinkler Repeir/Mainl lJ Other <br /> CONTRACT PRICE OF WQRK ��75-��� I Clri O�EVERETT LOCAL SALES TAX CODE IS�106 I <br /> 7 <br /> WORK DEBCRIPTION <br /> N� ST�2 c�srn�_ncr.1 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM NO. TVPE OF fIXTURE OR REM I' <br /> � WATER CLOSET � A/C-AiHANOLINO UNITS II <br /> BATH7UB � FORCED AIR SVSTEMS <br /> LAVATORY(WASH BASIN) � HEAT PUMP <br /> � SHOWER � UNIT HEATERS <br /> _L KITCHEN SINK d DISPOSAL � CLOTHES DRVER � <br /> ..J_ DISHWASHFR �_ FAAGE HOOD <br /> '�_ LAUNDHV TRAY � WATER HEATER <br /> � CLOTHES WA5HER METAI FIREPLACE/STOVE <br /> �_ URINAL FIREPLACE INSER( <br /> � DRINKI4G FOUNTAIN J_ QAS PIREPLACE <br /> y FLOOR DRAI�J GAS RANGE I <br /> � BACKFLOW PqEVENTER GAS PIPIN6 <br /> \ SWK(SEFVICE/BAR/MOP/_TC.) EXHAUST FAN <br /> �_ OTHER OTHEH <br /> I HEREBV CERITIFY THAT I HAVE READ AND EXAMW�iD TMIS APPUCATION AND I(NOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF L4WS!N�ORIDINACES GGVERNING THIS TVPE OF WURK K'ILL BE CJMPLIED WITH WHETNER SPECIFIED HEREIN OR <br /> N07 THE GRANTING OP A PERMIT OOES NOT PRFSUME TO GIVE AUTMORITV TO VIOIATE Ofi CANCEL THE PFOVISION OF RNV OTMER <br /> SiATE OR LOCAL L1W REGUTATINO CONSTRUCTION OR THE PERFQRMANCF OF CONSTRUCTION THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TC PERFORM TNE LYORK FOR WHICN APPLICATION IS MApE AND i COMV'LV WITH THE STATE <br /> CONTRACTOP� LAW 1B 27 qr.1Q(AN�298 200 WAC � � <br /> �J� �z-i� -oz <br /> ' o wnen ontractor uthonze genl ele <br /> _ �/�. � <br />