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---� — <br />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 <br />Zo �� 8��-�--� vre <br />LEGA LOTNO. BLOCK <br />DESC. <br />OWNER <br />� pS ✓Ca¢C m,..Au r} NmS <br />TENANTNAME <br />CONTRACTOR <br />�oei,.,su�. P�.N� . ,�,� <br />PHONE (?�p�yo3--��bt <br />PROPOSED USE OF BUILDING <br />S r-�z <br />CONTRACT PRICE OF WORK <br />WORK DE9CRIPTION <br />/�J L >r4'�� <br />� <br />PARCEL TAX I.D. k <br />TRACT <br />CONTACT FOR PERMIT <br />ADORESS <br />a933o ia�n+ A�r' �t <br />i4-C � , i.. (i1'-d...i <br />Bullding DMechanical <br />PERMIi �Combinetlon B Plumbing <br />TYPE DemoliliOn Sign <br />Sprinkler <br />� � o-e <br />F.Rr Sv�•••-Kcue <br />TYPE OF fIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <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 />BACKFIOW PREVENTER <br />SINK (SERVICE/BAR/MOPIETC.) <br />OTHER <br />ZIP <br />Qp217 <br />PERMIT M <br />CONTR.UCENSEM <br />/�0�6 irP � L7 Lc j <br />AddlOon I HEATSOURCE <br />tere0on Electdc <br />New � Gae <br />RepalrlMalnt. Olher <br />CITY OF EVERETT LOCAL 8ALE8 TN( CODE 19 7703 <br />s y s rrr�+ i..i ti. r,.... S r7e <br />NO. <br />TYPE OF FIXTURE OR IiEM <br />A/C - AMANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES ORYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACFJSTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />N� M1 S <br />I HEREBY CERITIFY THAT I HAVE READ AND E)(AMINEO THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF IAWS 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 AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br />STATE OR LOCAL LA1Y REGULAT�NCa CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF TMIS PROPERTY TO PERFORM THE WORK FOR WNICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTEO <br />