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--t — � — ; ,: --� <br />RF'FiMIT APPLICATION ��;- � -� <br />a,� CIT'Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 � I �j �• <br />425-257-8810 — FAX 425-257-8857 <br />_ acs9zsvv��s� <br />SITE ADDRESS\. _ , I PARCEL Tl�( I.D. !1 � �, PERMI7 k <br />LEGA LOT NO. . <br />DESC. �` <br />TENANT NAME <br />CONTRACTOR <br />PHONE �i �_ <br />� � J r11�.�.1'.1'I <br />��1�i _ �,xrx� � <br />PROPOSED USE OF BUILDING <br />Si <br />.�-. � <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTIO <br />��.1� � <br />THACT <br />CONTACT <br />PHONE <br />� � � <br />ADDR SS ZIP CONTR. UCENSE M <br />C�N��. S1� i.. Dc�,:�� ���P �td N��{. <br />U� . 51c�ft�1� Wn aet�x • <br />�uilding D Mechunical <br />PERMIT Combinatlon �j Plumbing <br />TYPE Dnmolillon U Sign <br />Sprinkler <br />Addition <br />WORK Alleration <br />rrae Ne�, <br />ReyeirlMaint. <br />HEATSOURCE <br />Electric <br />oag <br />Olhar <br />CITY OF EVERETf LOCAL SALES TA% CUDE IS 3f 05 <br />Ne�a I(o�tB � SF.iZ. <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATG�iY (WASH BASIN; <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASH[R <br />LAUNORYTRAY <br />CLOTHESIVASHER <br />URIWAL <br />DRINKING fOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (S[RVICE/BAR/MOP/ETC.) <br />CTHER__ <br />NO. I TYPE OF FbCTURE OR REM <br />�� <br />A/C — AIHANDLING UNITS <br />FORCED AIH SYSTEMS <br />H[AT PUMP <br />UNIT HEAT6RS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATERfiEATER <br />METAL FIREPLACE/STOVE <br />FIREPLl10E INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER __ <br />I H[R[BY CERRIFY THAT I HAVE READ AND ExAMINED THIS APPLICATION AND KNOW THE $AME TO BE TRUE AND GORF7ECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES G�JVERNING THIS NPE OF WURK WILL BE COMPLIED WI1H WHETHEh SPECIFIED f1EREIN OR <br />NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTfiORITY TO VIOLATE OR CAACEL THE PROVISION OF ANY OTIIEF <br />STATE OR LOCAL LAW R[GULATING CONSTRUCTIO�I OR THE PERFORAIANCE OF CONSTRUCTIO��. THAT I AM AUTH�RIZED OY TfiE <br />OWNER OF 11115 PROPERT't'�TO PERFORM THE WC'r;K FOR WHICH APPLICATION IS A7ADE AHD I COMPLY WITH THE STA"i E <br />CONTRACTOPS LAW:Y027 R�W AND/�96.200A�AC� <br />2 e:0 QL• <br />