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�cRMIT 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 ADDRES5 PARCEL TAX I.D.It g�MOI7 ab <br /> ��it �1�q � �/Vl '� � -�l <br /> LEGA LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADDHESS ZIP PMONE <br /> TENANTNAME CONTACTNAME PHONE <br /> ��q5 maPK mu.R��C �yas� as�-��� <br /> CONTRACTOR ADD ESS� ��,,�,,s�A ZIP CONTR.LICENSE N <br /> ,a��mw�s�r r�����rq I �� �v. ��►a,�6 q,��o7 <br /> PH0�.3G1>1335- tai� I.X,�-ns '�On � ��-5�w�' '4sf2�;i'�'"�` �' DA.���"�a��7c�d <br /> PROP EDU OFBUILDING pERMIT t-t Sprinklleation I ) Plumbingal W�RK �R�epev/MainL HEATSE�CC <br /> TYPE �_� Demolition � Sign IYPE New Gas <br /> IJ Other <br /> CONTRACT PRICE OF WORK� Oa� CITY OF EVERETT IOCAL SAlES TAX CODE IS 3105 <br /> WORKDESCRIPTON ��� �, (� -, �1�AYw�J�T . D�/ V �"^�1L <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF Fl%TURE OR ITEM <br /> WATER CLOSET A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIRCPLACE/S70VE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENiER � GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE i RUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIED WITH N;HETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERfdIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCC=L THE PROVISIOtJ OF ANY OTHER <br /> STATE OR LOCF.L L4W REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERPOR�d THE WORK FOR WHICH APPLICATION IS MADE AND I CUMPLY WITH THE STATE <br /> CONTRACJ�S�1827 RQW AtJD 296.200 WAC. <br /> �=� �� G'�'�� _ .�/�1,�3 <br /> Si�tUre of ner/Cont cto/Authorized Agent Date <br /> / DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />