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i'.'-____._'___"' <br />SITE ADDRESS <br />LEGALI LOT NO. <br />UESC T ?� <br />!- CRMIT APPLICAT�IJN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />� <br />�: , <br />BLOCK I TRACT <br />PARCEL TAX I.D. # <br />rt( r <br />PNONE <br />♦'� . <br />��1a�li��\:a,\;� Se l-'� (-10'S,3�'3S I���S� ��-�.*� �kot7- �la.l'`T43'l7lSs <br />TENANT NAME I CONTACT FOR PERMIT PNONE <br />�.��5 �.<SS�v�� 4�.s-�K3-��ik <br />CONTRACTOR <br />A c4 412 � Y�:u`� 5�5� L�C. <br />PHONE <br />ADDRESS tr ZIP CONTR. LICENSE C � <br />l"103a-�5 F1�rSF �oi1�Q�� 9�0�� <br />��OR� RC�o3�� 1 � <br />PROPOSED USE OF BUILDI�G I �uilding ���JJJiii Mecharical � Adtlrtion NEAT SOURCE <br />:--,7� �l <��,•;� �� m,vN. �,-� PERMIT �Combination �Plumhing WORK �IteraUon �Eiectt,c <br />TYPE Demolition D Sign TVPE ew Gas <br />"-"����"�� Sprinklef Repart.Alart•�t Other <br />CONTRACT PRICE OF WORK �jr (}� C" CITY OF EVERETT LOCAL SALES TAX COO! IS J105 — <br />WORK DESCRIPTION �Ny�,��.s'� ` <br />�iv�.JJ l��k��%u��dc-~- O` --�l�w`Lil.�it-15J.\L�V�Y <br />v u <br />,�9u1�1.[�7 <br />NO. I TYPE OF FI%TURE OR ITEM <br />� WATER CLOSET (TOILET) <br />�' _ BATHTU� <br />�j_ LAVATORY (WASH BASIN) <br />ISHOWER <br />�'�, KITCHEN SINK 8 DISPOc�,! <br />� DISHWAShER <br />� ' I.AUNDRY iRAY <br />��CLOTHES WASHER <br />. _ _ �I URiNAL � <br />I DRINKING FOUNTAIN <br />� FLOOR DRAIN <br />IBACKFLOW PREVENTER <br />SiNK (SER\'ICE l3AR%h1Cv ETC ) <br />�t OTHER 12ac.�__�4.1,••n <br />� 7c-;�.� 3-� -1 <br />NO. � TYPE OF <br />lVC -AJHANDLING UNIT� <br />�_ FORCED AIR SYST-E=�.15 <br />_ HEAT PUMP <br />UNIT HEATERS <br />�_ CLOTNES DRI�[�R <br />_� RANGEHOOD(�»ikP,� <br />�_ WATER HEATER <br />METAL FiREPIACE � �"C'rE <br />FIREPLACE INSE�RT <br />l GAS FIREPLACE <br />� GAS RANG[ <br />_� GA� PIPING <br />_ �i EXHAUST FF,N <br />! OTHER _ <br />�-�+[9Y CERITIF� TMAT i HAVE RE4D AND EM6uNED THIS APPUCATION ANU KNOW TNE SAA1E TO BIE TRUE At+D COHRF:CT �L� <br />�� . S'�ONS OF LaWS AND ORIDINACES GOVERNrtJG'H�5 TVPE OF \1'ORK IV�LI DE CO'dPUE�7 Y:ITH'�1'nE i HER SPEGFFD HEREiN C? <br />.''hE i�RA1JTiNG OF q PERM1i�' DOES NO7 P7[SUh1E'O GI\'E %.UTnOR17�' TO'�: iC'�..F�.TE GR C�NCEL 7NE PROV15�^uk OF:.Nv OTnE � <br />.'i= OR LOCAL LAIh' REGULl�TING CONSTRUCTii;'. CR'!�E PERF�)1:t,!:.NC[ OF ��tiS7RUCT�CFJ TNAT �. afd AUtMO�i.Z[�' J'+'tic <br />.. t=R OF TNIS PROPERTV TO PERFORM TNE 1YORF �OR IYHICH AF°uCATlO'`! 15 L1qUc AND . CvA1P:Y' l':iTM 7F�E STFTE <br />'•'�iACTORS LAW 1827 RCtV AND296.200NFC. <br />; yi <br />- '_ ,� ���_ o� <br />.�� nw�3 - t OwnenComractocAu ��:i:.�e�: ,��;e�n Dete <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTEU <br />� <br />r�%Ld.�� �%p.�p - — - <br />, j��l'�) <br />