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4 ` . <br /> � • PERMIT APPLICATIQN <br /> CITY OF EVERETT PERMIT SERVICES <br /> + 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 1 425-257-8810 —FAX 425-257-BB57 <br /> ( SITE ADDREES PARCEL TAX I.D.N PeRM T a <br /> ' looi W Cq51uo RD �C.v6 • C oG�i-3loo0000 oa �' - <br /> ' LEGAL LOTNO. BLOCK TRACT <br /> DESC. � � <br /> i OWNER ADDRESS ZIP PHONE <br /> ����ort���k� t�F.�ttw�� W k �98204 4Z5 sis �9331 <br /> TENANT NAME CON LAC-T FOR PERMIT PHONE <br /> I?��4G1�G t'A!(o11J�pE}tl� `(�C}{ Zo� ZBI '15� <br /> CONTRACTOR AODRESS 21P CONTR.LICENSE N <br /> `I� 'P,�E �`I�itw� 1� f� 131 D pi'tv C.655 <br /> PHONE <br /> PROPOSED USE OF BUIL�ING I �uilding f1 Mechanical I � Add�tion I HEAT SOURCE <br /> PGRIdIT COmbinaiion f-� Plumbing WORN nitma��on Cleclnc <br /> R-I eoubom�NiN� �.pE Demoli(ion �j Sign TYPE N�w � cos <br /> Sprinkler RepnirnAainl Olher <br /> CONTRACT PRICE OF WORK � '�5d�,�j� CITY OF EVEREIT LOCAL SALES TAX CODE IS J705 <br /> WORK DESCRIPTION�e� <br /> Sc-� �tTi/4c�\�� <br /> PI.UMBING MECHANICAL� <br /> NO. TYP[OF FI%TURE OR IT[1.1 NO. iVPF.OF FI%TURE OR ITEM <br /> VJATERCLOS[T � A/C-A/HANDLINGUNITS <br /> BATHTUO FORCED AIR SVSTEAIS <br /> LAVATORY(WASH DASIN) HEAT PUMP <br /> SHOINER UN��f IIEATERS <br /> KITCHEN SIt:K 8 UISPOSM. CLUTHES DRYER <br /> DISNWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATE-R <br /> CLOTHFS W�SH[R 1,1ETAL FIREPLFCElSTOVE <br /> URIN�L FIREPLACE INSGRT <br /> DRINKING FOUNT�RJ GAS FIREPLAC[ <br /> FLOOR DRA�N Gl,S RANGE <br /> OACKFLOW PFc-.V[NTLH GAS PIPING <br /> _ SINK (SERVICElBAR�RIOP'fTC.) E%HAUSTFAN <br /> OTHER OTHER <br /> I HER[OV CERITIFV THAT I NAV[ RfAD AND EEXA�1 W[D TNIS APPUCATION AND NNOW TH[SAAfE TO�E TRUE AND CORRECT. ALL <br /> PROVISIONS OF I.:tVS AND ORIDINACES GOVERNING TI11S T�PE OF VJORH IYILL BE COh1PLIED INITH ll'HETHER SPf_CIFIED HEREM OR <br /> t10T. THE GRAN7iNG Of A PCRIdIT OOES NOT PRESUAIE TO GIVE AU7HORITY TO VIOLATE OR CANCEL TNG PROVISION OF ANY OTHER <br /> STAT[OR LOCAL�A17 RfGULAT IkG CCNSTRUCiION OR iH[PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORVZED BY TME <br /> Ol5'NER OF 7H15 PROPERTV TO PfRFOR�d THE WORK FOR WMICH APPLICATION IS AfADE AND I COM17PLV WITH TNE STATE <br /> CON124CTORS LAl'✓1P?7 RC�V FND 776 700 PJAC <br /> � � ._�f���� C��'�C� (o �t,b✓D� <br /> S gnatu ol OwnedCon raUod�ulhonzed Agent ate <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �/ <br />