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�ERMIT APPLICAT" �N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDR S PARCEL TAX I.D.p PERMi7 tt <br /> /CQ l /�akFv �� vay3��33� �.� <br /> LEGA LOTNO. BLOCK TRACT <br /> D'cSC. <br /> OWNER ADORESS ZIP PHONE <br /> �����c� .I��o�-,I'e�� /��� /3�k-o:- �_ �'io��i� yP�o/ <br /> TENANT NAME CONTACT FOR PF.RMIT PHONE <br /> .J'`2nc.c�, �(.-�i1d� yzs 275- S '�5� <br /> C0�?�C�� �,`�� ������ ADDRESS ZIP CONTR.LICENSEN <br /> PHO���1 � pz (� -� y�„� h�/y;,y� �-dc k�e //�J� �� 4)p�yd Ec�"/�ffl/�J'97/ag <br /> � '.'D L 7 7GU �w �tl�i-��. �W r N II I <br /> PROPOSE� OF�LDING I TMPE�T BSprinklle�rnn �Sgnbin9al ITMPE afl-RepairlMaint. I HEA�OOIhRCE <br /> G <br /> CONiRACT PRICE OF WORK G� — CITY OF EVERETT LOCAL SALES TAX COOE IS 7105 <br /> � <br /> WORK DESCRIPTION <br /> C��� l�J<�r �<t� �e,p,�co���f <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE 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 METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRIIJKING FOUNT/11N GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICEIBAR/MOPlETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I — — - — <br /> I I HEREBV CERITIFY THAT I HAVE READ AND E.XAtriWED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDIWICES GOVERNING THIS TYPE OF lh'ORK WILI BE COMPUED WITH WHETHER SPECIFIED HEREIN OR <br /> � NOT. THE GRANTING Of A PERM1IIT DOES NOT PftESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> Sl'ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OV/NER OF THIS PROPERTV TO PERFORAI THE N'ORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTR CTORS LA .27 RCW AND 2962001�. L1/�D� <br /> G1.+.���, lC/i / C_� <br /> Si at re of OwnedContractor/A i rized Agenl Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> �_ _ -_ - - -- - --- - - - - -.-. <br />