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PERMIT APPLICATION <br />CITY OF EVERETT P�RMIT SERVICES <br />320C� CEDAR STREET, E �[RETT, WA GII�U1 <br />425-257-8810 - FAX 42:,-257-8857 <br />�4 u1,�q uJvaAl <br />n?o��z i3s 7 t� <br />g�s,c� zZyy <br />_ - —+— - <br />SI�tE ADDRESS �i, � � �/ � Ll1 PARCEL TAX I.D. # � -al.� - : <br />� � � � ���1��—��i l ✓G � � � <br />-� —� ---- ------ � o � 05 ` /� "> <br />. .. LO7Np ' BLOCK ! TRACi <br />. ...' . — __ I _ _'__. <br />uP�NF'.ft � � ......� — ADDRE55 ZIP PMONE <br />CmS �c�ttlSur�Jrrt� �NC � Q� /57 �� Hfu/��'' � 1 3� 3- u0� <br />--.� 6 X-- 9_,vof/o.h,r ..`11 �'i r� 1r <br />iLhANT NAME CONTACT FOR PERMIT PHONE <br />� Caar�t /�ia�c,ja.J �c�2.� 35'y-��oo <br />CONiRACTOR A��RESS <br />C,.�.� SA..<< a s pdo uE <br />�>� r,e <br />��{ 2J—) 3 S 3-�j o00 --- — <br />PROPUS[D USF OF 6UIl 71NG ((( dwlAin� Mech,�ni[al <br />PERMIT � Com�inafion � Plumbing <br />t, r� TVPE � Demolilion Sign <br />J iJ S�mnk!er <br />. . _-- - . .. .. ._-- ------ <br />coNrancraaiceorvrorzrc `x��0�opp <br />__..__ ._____- . _ ._ _ ._ <br />WOP.K DESCRIPTION <br />CtNS�� Ndi-•1 -iFiL <br />PLUMBING <br />Nc� iYPE OF FIXTURE ORITEM <br />3 , .I r_ Ue��/E ��� <br />Z . ;. „r w r 1 <br />� , �,��.r1TOR\ (VVA$H EASINI <br />".,� ���,VER <br />� �.�!�:HENSWKSDISPOSAI <br />� I��`�iil;'ASH[R <br />�.��uNDRY TRAY <br />I � .'. �HES WASHER <br />��11iNAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />_ _ BACKFLOW PREVENI'ER <br />_ SiNK ISERV�CE�BARiMOPiETC.) <br />ZIP CONTR, LICENSE u <br />Cwirsnl *�oBsn�3 <br />� A�t�.la.u; � HEAT SOURCF <br />WORN Allera!�cn I � F.,. . <br />TYPE New <br />ReUa�r�Ma�nt � �� �� . <br />CITV OF EVERETT LOCAL SALES TAX CODE IS ]tn� <br />MECHANICAL <br />N0. I TYPE OF FI%TURE QR ITEM <br />ac -nFinN��.,r, - . <br />I FORCED AIR S'� ��'. . . <br />HEAT PUMP <br />UNIT HEATER`, <br />J_ CLOTHES DR�I '� <br />�. RANG[ HOOD <br />1,_ WATER HEATFI- <br />METAL FIREPI!•� ' � . � <br />FIREPLACF M'�•i '+' <br />= GAS FIREPL�CE' <br />GAS RANGf: <br />3AS PIPWi3 <br />i EXHAUS7 F�;�� <br />_I OTHER___ <br />_� <br />- "� CEFITIF� ?HAT i HA\�E READ AND EXAh11NED THIS APPLICATION AND KNOW TMF. SAME TO BE '�,. � ., -��� '�� <br />... �_iNS OF �a�yy :�,yp i)RiU�NACES GOVERNING THIS TVPE OF WORK WILL BE COMPL�ED NITN WME'r�i=�: �P�C,i �i_:. ��P�t ��_ <br />• 1,^F. ;;::<,': •`. ��F :, ::f �t'd�T DOES NOT PRESU6fE TO GIVE AUTHORITV TO VIOLATE GR CANCEL 7HE PROVISION OP ANv pTriGft <br />,�-F. �� r:,,� _.,;\ kc�.7,,ty,-�IJG CONSTRUCTION OR THE PERF4R",1ANCE OF CONSTRUC'� iOP; rMAT i AA1 4UTHOFIZED B�' '�E <br />'•�vE�e ��°'�+�5 ���e�:���E LF TO PERFORM THE WORK FOR WniCn 4P���.�,CnnON iS f.�.4DE aND i�;UM1�P�v bV�rH -;1E 57qTE <br />�yir �.)�t5_FC.�t:7RC.NaND296200WAC. <br />' s s�o S/ <br />._:. �e af Oti ne�-ConlraclorAWhom, rd Ayent Da�e <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />