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� �cRMIT APPLICATIt�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE'TT,WA 98201 <br /> 425-257-8810— FAX 425-257-b357 <br /> �v3o7 -/a� <br /> SITE ADDRESS PARCEL TAX I.D.N y�RMIT N <br /> D �fUsRsni �0 3aS7 Doo ooa o0 I b��y-d� / <br /> LE6A LOTNO. BLOCK TRACT <br /> DESC. <br /> N ADD E 8 <br /> Q��k Aae� ��2o AI��QSa� �1�� y�ao� <,�- �- �0�3 <br /> TENANTNAME CONTACTFORPERMIT PMONE <br /> SAME I !'c�g ���C�..v- ( �25� �Ss-3zZ`� <br /> CONTRACTOR ADDREss iIP CONTR.LICENaE M <br /> PHONE Duf�j�� <br /> PROPOSEOUSEOFBUILDINO Bulldlnp MeChanical Addltla� HEATsOURCE <br /> PERMIi Combinatbn R f'lumbinp WOIYK �qReratlon �'Ekctrlc <br /> TYPE Demolitlon p Slgn ME New D (�, <br /> ,�E� Sprinkler RepalNMalnt. U oms� <br /> CONTRACT PRICE OF WORK CITN OF EVERETT LOCAL sALEs TAIt CODE It NOs <br /> WORK DElCRIPTION <br /> ���-- ��� <br /> PLUMBINO MECNANICAL <br /> NO. TYPE OF PIXTURE OR ITEM N0. iYpE OF FD(TURE OR ITEM <br /> _ WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> _ BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> _ KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> _ DISHWASHER RANGE HOOD <br /> _ LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METALFIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER CaAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I IIEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNO'N THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITN WMETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONS'(iUCTION. THAT I AM AUTMORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITN TME STATE <br /> CONTRAC RS LAW 78.27 RCW AND 298.200 WAC. <br /> ��,���� '�d3-o3 I <br /> natu o wne ntractor u onzed gent ate � Z <br /> 0�'`�'�'� �'� DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 1 <br />