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PERMIT APPLICATION <br />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. p P�RP.11T # � <br />i��v 75 T'' sr 5,�. �� c���_ �� <br />LEGAL LOTNO. BLOCK TRACT � <br />UESC. <br />OWNER AODRESS ZIP PHONE i <br />�li�% ���E1��L ��L����/� ���:� ���`� ,�� Td���O'��Z��� <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />� /nl/C� �tA � � r S�:�S - �70 -/� �u I <br />CONTRACTOR <br />� <br />%1�1 �G � �_��r1S�_ <br />�. PNONF. �LUMG (_�i�A� j� <br />i <br />� PROPOSED USE OF BUILDING I <br />5i��;�� �'��, i�t> <br />ADDRESS 7 <br />��.3:.!/ •,LNG' At�C.. l�,�J. <br />%U���1i�� <br />Building IIIiii Mochani�al <br />PERMI7 Combination � Plumbing WORI <br />TYPE Demolitlon Sign TYPE <br />Sprinkler <br />21P CONTR. LICENSE N <br />`l�� i/ /�Jq[o yc •� �70�a <br />RAddition HEATSOURCE <br />Alleration n Elednc <br />��� New F� Gas <br />�m� Repair,Mainl. LJ Other <br />CONTRACT PRICE OF WORK 3 J S � �v- I CIIY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I WORKUESCRIPTION pE-PLACL' <br />I �� ATcn, <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATIiTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 3 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLUTHES WASHER <br />URINAL <br />DRINKING FOU�TAIN <br />FLOOR DRAIN <br />OACKFLOW PREVENTER <br />SINK (SERVICEr�AR/MUP�ETC.) <br />OTHER <br />� <br />�����T �' �A r,�%v� �� <br />�inrE� /n1 h'�-oSF <br />REP��s �` <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - A/HANOLING UNITS <br />FORCED AIR SYSTEh1S <br />HEAT PUM1'P <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HE.4TER <br />MGTAL FIREPLACElSTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />E�HAUSTFAN <br />OTHER <br />i NEREBY CERITIFV THAT I HAVE READ AND EXAAIINED THIS APPLICATION AND KNOV2 THE SAMF TO BE TRUE AND CORkECT. AlL <br />nROVi510NS OF L4WS AND ORIDINACES GOVERNiNG THiS TYPE OF 1YCRK WiIL BE COMPLIED WITH WHETHER SFECIFIED HEREIN OR <br />'JOT. THE GRANTING OF A PER611T DOES NOT PRESUWE TO GIVE AUTHORITY TO VIOI 4TE JR CANCEL THE PROVISION OF ANY OTHER <br />57ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORM1IANCE OF CONSTRUCTION THAT I AM11 AUTHORIZED BV THE <br />ONJNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS h1A�E AND I COMPLY IVITH THE STATE <br />Cl1NiRACT(1RF I AW 1fl 27 RCW AND 296:00 IVAC. �- U�� <br />� � �' �"�� �f <br />7NuthoriZecl Agenl uale <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />B/�� LJi � <br />0 � <br />