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PERMIT APPLICATION m ��z' A �J� <br />CITY OF EVERETT PERMfT SERVICES g�.s rc`� 224Z ! <br />�3200 CEOAR STREET, EVERETi, WA 98207 i <br />I�� L� 425-257-8810 - FAX 425-257-885? <br />SIT ADDRESS PARCEL TAX I.D. # PE :Mi7 a <br />� Z� T3R° P�ac.sSu1. <br />LEGAL LOTNO. BLOC�TRACT <br />--- '��_ <br />resc 28 1 Z 9 <br />OWNCR AD�RESS ZIP PHONE <br />C�►+S F1a,.�sl�u�w�, iNc , e06�X/57q, s..�af/o.hrlH,u/A �1�291 �°;tT) 353-/�ue� <br />TENANT NAME I CON7AC� FOR PERMIT PNONE <br />I C2a�s ��i,tRrro,.J (c{2,� 35-q-l000 <br />CONTRACTOR ADDRF.55 <br />C'M.r 1��C R s f►.Ba uS <br />P NE <br />_ �{Zj � 3S3 —q000 <br />PROPOSED USE OF BUILDING BuilOiny MCCh3nic21 <br />I PERMIT � Combinaliun R Plumbing <br />��' F� TVP[ Demolilion � Sipn <br />Spnnkler <br />CONTRACT PRICE OF WORK — �// ���0 <br />CO <br />WORK DESCRIPTION <br />Gw s r-ww..r ,v d-w S� Q _. <br />N0. <br />Z�P CONTR. LICENSE p <br />C►�s'snl*�ogsiy3 i <br />-- � <br />AJailion HEA� SOURCE I <br />WORK � Alteranon I � Eleclnc , <br />TYPE New Gas � <br />RepairrMaiN. Oiher � <br />= rq� �`I CIN OF EVEREiT LOCAL SALES TA% CODE IS J705 <br />� <br />C0�lsraK'� I�NP6fX 5���1=C� <br />/ Tf,�,�n�N6 — 2 uN�rs w�'s'F/ <br />, j}�rL o� qDOQET! <br />r��mol(vu t�N ��DE N�� <br />TVPE CF FIXTURE OR ITEM -r� ��dw� � <br />WATER CLOSET (TO�ILE�J) � <br />EATHTUB w/ J144+( FFiM�N J <br />LAVATORY(V�'ASHBASII� � <br />SHOWER <br />KITCHEN SINK 6 DISPOSAL <br />DISIIWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />AACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/E 1'C.) <br />OTHER _ <br />NO. � TYPE OF FIXTURE OR ITEM <br />IWG -A/HANULING UNITS <br />� FORCED AIR SYSTEMS <br />__ HEAT PUMP <br />UNIT HE.4TERS <br />� CLOTHES DRYER <br />�� RANGEHOOD <br />'2,1_ WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPLACE INSERT <br />?� GAS FIREPLACE <br />�AS RANGE <br />� GAS PIPING <br />�� EXHAUSTFAN <br />� � HEREB" CERITIFY THAT i HAVE REAU AND E?(HA1iNED THIS APPLICATION AND KNOW THF. Sl:0.!E TO BE TRUE AND CORRECT A� L <br />'. ��ROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WIL� BE COMf-�.IED WITH WMETHER SPECIFIED HEREIN OR <br />� NOi iHE GRANTING OF A PERMIT DOES NOT PR[SUME Tp GIVF AUTHORITY TO VIOLATE OR CANCEL TME PROVISION Of oNY OTHER <br />, �TATE OR LOCAL LAW R GULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTR�CTION THAT i AM qUTHORIZED BY TNE <br />� O�;'NER THIS PROPE TV TO PERFORM THE WORK FOR WHICH APP�'�CATION IS IdA�E AND I COMPLV WiTM THE STATE <br />! CONT ORS LACJ 7 27 RC'N AND 296 200 WAC. <br />-- - � S�s�o �/ <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />' /2 <br />