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�ERMIT APPLICATIUN <br />G4TY OF EVEREiT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />S�TE ADURH�SI <br />��Y � c <br />LEGAL LOT NO. � BLOCK <br />o�so. 4 d f <br />OWNER <br />1-�L � � � . <br />TENANTNAME <br />1 V� <br />CONTRACTOR `1�7„N,'I <br />(.�l I Y. <br />PHONE _.__.____—___—__ _—__ <br />PP.nPOSED USE Of IlUIL01NG <br />i'ERMIT <br />_' �—� ..��0.�_V�1I��1U TVPF. <br />C9NTRAC'f PHICF. OF WO,�tK � <br />;V��RKDESCRIPTIUN I�V�,",^y1�,'�7K�1� <br />I l. � uJ l u4a �-� <br />--------- — PLUMUING----- <br />NO. I T'!PE OF FIXTURE OR IiEM <br />3 WA fER CLOSET <br />� O�ffiTU� <br />_ �P.VATORY (WASH OASItJ) <br />..� S'10W[R <br />� I�� Il CI ILtJ SINK 8 UISPO ;!J <br />� I11>HW�SNt7t <br />-- � AUNURY 112/�'i <br />, CI OIH[S WASH[If <br />— uitirini. <br />� ORINKI"1G FOUNI��I;J <br />� FL(1CiRDRNM <br />�_ O11CKfLOW PIiCVf_N i Eft <br />_ - SINK (SFRVICL/UAl2/MUPl1?TQ) <br />r— (11HCR -- - _ <br />(1RCEL TAX I.D. M <br />TR CT � � <br />�2 �Z—/6— <br />AODRESS <br />� 1 � 'l <br />CONTAC7 FOR PERMIT <br />1�i�,Y��1C �At1���'�'� <br />nooRess <br />Ruild+ng <br />Combinnliun <br />Duntolilion <br />Sprmklcr <br />M <br />PHONG <br />ZIP CONiR. LICENSE M <br />------- Ny`^� _-�?C�v�--�v ` " <br />�Mor.henic:ll Addiliun fIEAT SOURCE <br />f'lumbin� 'NORK AllerFiliun I _yf-..��_Elm:ldr. <br />Siyri ITYPE �aw iY.SC�a� <br />I� RnpnldMalnl U Olhm <br />CI1Y Of EVERFTT LOCAL SALES TAX CODE 19 �105 <br />� � 224 7 <br />NO. I TYPE OF FI%Tl1RE OR ITEM <br />NC - NHANDLING UNITS <br />FORCED AIR SYSTEMS <br />h1EAT PU1.1P <br />I1NIT HEATEFtS <br />CIAIIi[S DRY[R <br />I</�Nl7E HOOU <br />�NAlflt H[nTCl2 <br />r.ieini ni�tr�nc�_istove <br />fll![PI.11C[ INSFRT <br />GPS FIREPLACC- <br />G/1S Rl�NCF <br />GAS PIPING <br />C-XH�USTFAN <br />OTHEIt. -_.._----- <br />I Ilf-RGBV l:Llil IIfV 111A1 i IIAVL HI:AU ANU [%A611NCU I1115 APPLICATION AI�O hNOW f11E ^,AM[ f011F_ 1RUf_ �NO COHRFCT ALL <br />PROVISIONS Of 1 �WS ANU �1RIItlNACE ; GOVL'RNING 111151YPF Of WORK WILL BB COMPLIEU WIIH WHETHER SP[CIFIED H[REIN OR <br />MUI �IIf_ GRANIMG Of A PI Rfdlf UUF ; N(li I'Rf 51111f I�) GIVG �UTIIUIIIIV 10 VIOI.AT[ OR CAIJCFL lllE PROVISIi)N OF ANV OTNER <br />S�fA7[ OR LOCAL IAW RFGUT Ai1NG r,OI1;TRU1:110N UR 1HF PFRfORMANCF. OF CONSTRUCTION THAT I AM AUTHORIZED BV TNE <br />OWNF OF 71115 PROf`ERTV f O Pf f7PORA1 TFIf WORK POR WHICII MPLICAiION IS h1ADE AND I COMPLV WITH THE STATE <br />'ON R CTORS LAW 10 2/ Rf.W ANU i91i 200 WAG <br />;ii� n�um nnrll;rnlrsr.toiiAulhr�iii�edAyr.nl�--�-- -- D�lo <br />DF..[�IT & CREDIT CARUS ARE NOT ACCEPTED � <br />