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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT a <br />L OI S 4,0o', y 0�'180.$0$ -0o- — <br />LEGA LOT NO. BLOCK TRACT <br />DESC. <br />ff�tRot.O (.J,1� 7�Ls <br />IS cYPRd, `YAINLUM6141✓i <br />,go 6 - .3-21- g7('&/ <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />7?)14 --T j7)�uP�JTpcagT 3 G 0 - �S.9 53 yv <br />CONTRACTOR <br />PHONE <br />ADDRESS <br />ZIP <br />CONTR. LICENSE 0 <br />PROPOSED USE OF BUILDING <br />al <br />dition <br />HEATSOO CE <br />PERMIT <br />k Comiilneation <br />U Plumbing <br />WORK <br />H <br />hctric <br />I <br />TYPE <br />Demolition <br />U Sign <br />TYPE <br />New <br />LLKn_J( Gas <br />SprinkY <br />Repaition <br />er <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />WORK DESCRIPTION ` <br />(lrh✓Nfz <br />.� <br />— j1��}� arm r <br />I <br />a / r'5��,fz4L <br />X l a <br />is011.01Ae <br />3 .\ 1 <br />PLUMBING, <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />_ <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />I HEREBY CERTIFY THAT; HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER 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 CONSTRUCTION. THA F I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT T LAW <br />/11§47 RCW AND 296.200 WAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />