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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 />.�QJ � � <br />LEGAL LOT NO. <br />DESC. <br />OWNER ,,//11 / <br />��Ip�� i.a bs �/% <br />TE�N `NTNAME <br />f�/�/�t+'�' �ULI.S <br />� <br />TRACT <br />CONTACT FOR PERMIT <br />��{Pve <br />I.D. q <br />'00�05000 <br />L 3oS-�ll <br />PERMIT t! <br />.S .3oS- 00 <br />�77-7zZ�1��6 <br />PHONE <br />yzs- 7�� l ��5� <br />CONTRACTOR � ADDRESS •�- � ZI CONTR. LICENSE # <br />`i �rn /Y%�brJN��:�� �sS�c 6 7zS 7J�{S�?" �t.v J�O�S 7i.n�h��o�/'�� <br />PHONE���_�/Z'�ZL/� �/rl�� (�1S //�*��/C� <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />WORK DESCRIF%TION <br />� ,�,��• lC <br />Building Mechanical <br />PERMIT R Combination� Plumbing <br />TYPE Demolition Sign <br />Sprinkler <br />� �/t'.-Pe J�.v.�.17/LLC <br />,%�" '� �G � <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTU6 <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />_ SINK (SERVICE/BAR/MOP/ETC.) <br />_ OiHER <br />Addilion HEAT SOURCE <br />WORK Alteration D Electnc <br />1YPE New U Gas <br />RepaidMainl U Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />��d %�.5�?ri.>k=e C�� <br />5���� d,o C,��'sD�.3.; °O ` ° <br />� <br />TYPE OF FIXNRE UR ITEM <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUG AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK INILL BE COMPLIED WITH WFiETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO�ISION OP ANY OTHER <br />STATE OR LOCA W REGUTATING CONSTRUCTION OR THE PERFORIdANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF T PR PERTY TO PERFORht THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTO S Lp t6�7 RCW AND 296.200 WAC. / .� <br />.����Ji`��� � ���� � <br />rized Agent Date / �� <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED v ��L <br />