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SITE ADDRESS <br />LEGAL � LOT N0. <br />DESC. <br />DWNER <br />S�t- � <br />fENANT NAME <br />. � %/, <br />n <br />i - <br />� <br />P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />5 ��' <br />S I BLOCK <br />TRACT <br />SP I ZoZ -�(�,- <br />=�z � ��is <br />� CONTACT FOR PERMIT <br />CONiRACTOR ADDRESS <br />STEU.�� ToN�/ ,�riniDsvciZk c��,sr <br />PHONE <br />(9�r1 75.d-2� <br />PROPOSED USE OF BUILDING <br />S ` �� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />/z�is�s��z <br />NO. � TYPE OF FIXTURE OR ITEM <br />� WATER CLOSET (TOILET) <br />_� BATHTUB <br />Z LAVATORY (WASH BASIN) <br />�SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />_L DISHWASHER <br />LAUNGRYTRAY <br />�_ CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />_ S!NK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />z <br />ZIP <br />�l3iS sTiev�niNi= <br />t�n1%tCC W/Q �% <br />Building ��(�))) Mechanical <br />PERMIT Combination j� Plumbing <br />TYPL Demolillon � Sign <br />Sprinklor <br />f:C�7 <br />P�� U�a - vo � <br />PERMIT p <br />D�la-� -ODS <br />�4Z5�338 - 1S <br />PHONE <br />�n�' C_7�fk.Fl( <br />PHONE <br />) 754-zo 7Z <br />CO TR. LICENSE q <br />M� <br />Additlon <br />WORK Alteretlon <br />TYPE New <br />Repair/Malnt. <br />HEATSOURCE <br />Electdc <br />Gas <br />Olher <br />CITY OF .iVERETT LOCAL SALES TNC CODE IS 7705 <br />�a�� <br />TYPE OF FIXTURE OR ITEM <br />n/c: — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />i HEREBV CERITIFV THAT I HAVE READ AND E,YAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACEL GUVERNING TWS TVPE OF WORK WILL 8E COMPUED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING O,F A PERMIT DOES VOT PRESUME TO GIVE AUTHORITY' TO VIJLATE OR CANCEL THE PROVISIGN OF ANV OTHER <br />STATE OR LOCAL LA REGULATINGT�OPi&T GTION OR THE PERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHOR12ED BY THE <br />OWNFR OF THIS PERTY TO�ERF� M E WORK FOR WHICH AFPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTHAL"TOR 18.27 RC)q ANp'296. 0 WAC. <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />�� <br />