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�-=--- — <br /> I . PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-6857 <br /> , SITE ADDRESS PARCEL TAX I.D.M PER iT N <br /> IOOI V11 C�15i1►J0 '(tD fS(,Q6 � I'r OG�'��OOOppp 00 I .�'//'(�z <br /> �EGAL LOTNO. BLOCH TqACT <br /> DESC. s� � <br /> OWNER ADORCSS �Ip pHONE <br /> VICTbRih fy1RK. �iow1E OW� I ool w caf�wo ft� �f' � 2a'L ¢� s�s �331 <br /> .�55oG��h�or1: �o Kt►+�tiuwski t-�l�if � W h 982n4- <br /> TENANTNAME CON ACTFORPERMIT PHONE <br /> I�a.�n.ea�c.. nKut�'�r" zd�e 2e� �soo <br /> 7kLIFlG !.'IJbIIJCEI�CIWb 'I�CH. <br /> CONTRACTOR ADDRE55 21P LONTR.LICENSE N <br /> "I"b 'P,,E b6'i�`-�trvi I r�.� p,1� p�l D �2.v C.655 <br /> PHONE <br /> PROPOSEO USE OF OWLDING I � �uilding Mechanical I A_'ddion I HEAT SOURCE <br /> R-I eoueom►NiN�t PERMIT Combination Plumbing WORK RI-1AlicraGon �n-/ Eiec�nc <br /> TYPE Demolilion Sign TyPE J�,j New QSj Gm <br /> Sprinkler XSZ Repa�i:b�ain�. U Ot�er <br /> CONTRACT PRICE OF WORK � f�t,OO'�rj� LITY OF EVERETT LOCAL SAlES TA%CODE IS J705 <br /> WORK OESCRIPTION <br /> SG� �4TIY4�H�D <br /> W PLUM�ING MECHANIGA� <br /> NO. TYPE OF FI%TURE OR I7EId N0. I TVPE OF FlXTURE OR ITE1d <br /> _. VJATERCLOSET A/C—A/HANDLINGUNITS <br /> _ BATIiTUB FORCEO AIR SYSTEt.1S <br /> _ LAVATORY(N'ASH OASR2) HEAT PUMP <br /> , SH0INER UNIT HEATERS <br /> _ KITCHEN SINK 8 DISPOSAL CLOTH[5 DRYGR <br /> _ DISIiWASHER RANGE HOOD <br /> LAUNDRY TfZHY INAT[R HEATER <br /> CLOTHES WASHLR IdETAL FIREPLACElSTOVfl <br /> _ URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> OACKFL0IN PR[V[NTER GAS PIPING <br /> _., SINK(SERVICE�BARRAOP�ETC.) EXHAUST FAN <br /> ___ OTHER___ ____ __ <br /> OTHER <br /> I MEREDY CLIiITIFV iHAT I HAVG RfAD FND E%A"dINEO TMIS APPLICATICN AND KNOW THE SAAIE TO BE TRUE AND CORRECT. ALL <br /> PROVISICNS OP Ln1VS��:D ORIDINACFS GOVFRIJING THIS TVPH OF t1'ORK WILL GE COAIPLIED WITH\VHETHER SPGCIFIED HEREIN OR <br /> NOT. TH[GRANTING UF A PER'.1R OOES NOT PRESU'dE TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE PRQVISION OF ANY OTHER <br /> STATG OR WCAL LA•.Y RGGULATtNG CONSTRUCTION OR THE PERFORM1IANCE OF CONSTRUCTION. TNA1 I A41 AUTHORIZFD BV THE <br /> OL�NCR OF THIS PROP[RTV TO PLRFORRI TNE\YORK FOR l5'NICH APP�ICATICN IS tdADE�ND I CO'dPLY 1YITH 7HE STATE <br /> fptiTMCTOftS LACJ 18:7 RCIV Ft.'D?96 20011'�C <br /> 1�ZF� G��L.c%��-7 � Ab!/03 <br /> igna re ol OwnC�l�onfracloi�AuO�ori7ed AgeM p��e / <br /> DEBIT 8 CRFDIT CARDS ARE NOT ACCEPTED � <br />