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� <br />SITE ADDPESS <br />0.30� //$ti <br />DESC� v,f" b <br />CIVNER <br />�u ua ra.�� <br />TENANTNAME <br />PE�MIT' APPL�CATICI <br />CITY QF EVERETTT PEF�MIT SEi�V'ICi�S <br />3200 CFDAR STREET, EVEFETT, WA 98201, 425-257-8810 /�� �O� <br />PAHCEL TAX I.D. N <br />P/���- s�- oo9a7y-voo- <br />ADDRESS <br />CONTACT NAME <br />� ,�a-��,�a. T <br />CONTRACTOR I ADDRESS <br />�ie�` � G�c.�� �r �� I <br />PHONE <br />PROPOSED USE OF BUILDING <br />5F2 <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />PERMIT M <br />'6-vC C''ciio-oio <br />I PHONE <br />,�4 9Roo S J�f��s vs'i - a poo <br />�PHONE <br />y.tS )`y� $��.3 <br />ICONTR. LICENSE M <br />� Q4ad,P c �.?.�/�F <br />Builcing DMechanlcal <br />PERMIT �Combinetlon B Plurnbing WORK <br />TYPE Demolition Sign TYPE <br />Sprinkler <br />NO. I TYPE OF fl7(TURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SNOWER <br />KITCHEN SINK 8 DiSPOSAL <br />DISHWASHER <br />IAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />Df;INKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENIER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />� <br />Addition I NEAT SOURCE <br />Iteretbn R� Electric <br />New L►f Gea <br />RepeirRrlain'. �� Other <br />CITY OF EVEHETT LOCAL SAlE3 TAX CODE Ig 7+05 <br />i4Mi'y �GlI�LhCe.. �'}dSic. �'2%s� <br />3�� %'��t¢sa� C�+n�. <br />N0. I TYPE OF FlXTURE OR ITEM <br />A/C - A/HANDLINa UNITS <br />F��RCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATE9S <br />CLOTHES DRYER <br />FANGEHOOD <br />WATERfiEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />I HEREBY CERITIFv T11AT I NAVE READ AND EXAMINED THIS APPLICATION AN� NNOW THE SAME TO BE TRUE O,VD CORRECt. ALL <br />PROVISIONS OF 14V.5 AND ORIDINACES GOVEfiNING THIS NPE OF WOFK WILL BE COMPLIED WITH WNETHEfl SPECIFIED HEREIN OR <br />N07. 7HE r,qANTWG G� A PERMIT DOES NO7 PRESUME TO GIVE AUTHORIiY TO VIOIATE OR CA�CEL THE PROVISION OF ANY O7HER <br />STATE OR LOCAI V+W REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEU BY THE <br />OWNEF OF T41S PROPENTV TO PEFFORM THE WORK FOR WHICFI APPLICATION IS MADE AND I CO'�APLY WITH THE STATE <br />�^NTRACT0.9S LAW 18.27 RCW AND 296200 WAC. <br />'/L <br />