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SITE ADDRESS <br />$,'a %S-� <br />LEGA L07 N0. <br />TENANT NAME <br />CONTRACT <br />GJO(fd ��u.M.�Cnf <br />PHONE <br />3Ga - c,s s _ <br />PROPOSED USE OF BUILDING <br />,�- �o �S <br />CONTRACT PRICE OF WORK <br />WORK �ESCRIPTION <br />N0. <br />� /2 <br />� <br />FtRMIT APPL,lCATION <br />CITY OF EVERETT PEFiMIT SERVICES <br />;i20D CEDAR STREET, EVERETT, WA 9820? <br />425•257 8810 - FAX 425-257-8857 <br />' PARCEL TAX I.D. M <br />BLO K TRACT <br />ADORE3S <br />���.�ars 1� � 2/z� /,� <br />I CONTAC7 NAME <br />ADDRE$5 <br />1�.9�y o/� Sn,�.,n�56 Monrd� .�,9 <br />Snv !� oM. i �+ <br />D �uilding Mechanical <br />PERMIT I ) COmbinntion � Plumbing <br />TYPE � Domolition Sign <br />Sprinklor <br />�°�� .� s� �-s <br />TYPE OF FIXTUFE OR ITEM <br />WATERCLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />�ACKFLOW PREV[NT[R <br />SINK (SEFVICE/BAR/MOP/ETC.) <br />OTHER <br />' I PERMIT x <br />n ozo 3-0� <br />21P PHONE <br />r�4c YZS =.Z S2- 4G� <br />PHONE <br />ZIP CONTH, LICENSE N <br />96.�4e <br />wotF_FP/o3?cT <br />RAddltlon I NCATSOURCE <br />Altorallan �j Eleclric <br />BNaw Oas <br />Popoir/Melnt Olhor <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS J705 <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAI FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />� I HEREBV CERITIFY TNAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />, PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS TYPE OF \VORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOi. THE GRANTIMG OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIiV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />' STATE OR LOCAL LAW R[GULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM PUTHORIZED BV THE <br />OWIJER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />I CONTRACTORS LAW 1827 PCW A�0296200 WAC. <br />� <br />� /o �$ L.���� 3- z7-u <br />ISign�uro o� Uwn�;r/CoNraclor/Aulh��nzad Agen� Date <br />l <br />