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PE -?MIT APPLICATIC�; <br />OA CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425 257-8810 - FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D. 0 PERMIT M <br />ZS/ Z GLA!A,4t,e Ste_ dd r r�1 �yi2oZb ool Cbab(�-ppa <br />LEGA LOT N0. SLOCK TRACT <br />DESC. Z 6 <br />OWNER <br />AAd � x � 2 Q ZIP PHONE <br />T F944T /�EyGi,�o rIE,rT /Mari/ d C-64 17yz:?s y7sy?862sv <br />TENANT NAME CONTACT NAME <br />PHONE <br />EGGt �40AI z y2sV 386os-ff <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE <br />%�EKq,�T [iFUELoOn-tEi✓% �o Box 6L8 <br />PHONE SpZ 75— TrCKcWC1 zg# <br />PROPOSED USE OF BUILDING <br />213lin 5F P P <br />�i W <br />4y 5F iAOra& <br />CONTRACT PRICE OF WORK <br />Bullding Mechanical Addilion HEAT SOURCE <br />PERMIT Combination IRS Plumbing WORK Alteration III��� Electric <br />TYPE Demolition 1� Sign TYPE New GAS <br />Sprinkler RepairtMaint. Other <br />O n ' /. CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK Ut`3GNIM 1 IUN - <br />NO. ) TYPE OF FIXTURE OR ITEM <br />WA I LH CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />S!NK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />N0. I TYPE OF FIXTURE OR REM <br />AIL, - AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEArPUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <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 HEREBY CERITIF'� THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE'RUE ANC CORRECT. ALL <br />PROVISIONS OF LAWS AND OPIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHO i HER SPEC - L[D HEREIN OR <br />NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOt: OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR;,'.ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE ANC I COMPLY WITH -HE STATE <br />CONTRAobRS LAW 10. CW AND 29 . C. <br />/1 <br />Cjt, <br />