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PERMIT APPLICATICSnI 1 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> S�E ADCD_RES3 . , PARCEL TAX I.D.N PERMIT p D� ``�� / <br /> .� Cc� l � C� l/Y�p c-� �o <br /> DESC. LOT N0. BLOCK TRACT C'� �I "—� J �I —O � D � <br /> OWNE� �` � �DDRE33 � ZIP PHONE <br /> v� a- --U S' <br /> , <br /> TENANT NAME t ` �� ( ` ^C� CONTACT FOR PERMIT � PHONE <br /> � \ � <br /> CONTRACT(�t� �\��� . l � ADCRESS 21P CONTR.UCENSE• <br /> ��-C p C� �{�o/Sn � 5{� S � <br /> PHONE( �-1w�) �J'_O ' S� c�S J `UY K�� WF�, �gaog <br /> \ <br /> PROPOS�USEp!",B�ING pERM1T � Combinallon R Plumbing I WORK �Iepair/Maint HEATgEecVlc <br /> / <br /> 4 -�� � TYPE Demolltion � Sign TYPE New Gae <br /> 1`� Sprinkler Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> WORK UESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. I TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) AIC—AIHANOLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL LOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPIACE <br /> FLOOR DRAIN AS RANGE <br /> BACKFIOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER _ <br /> I HEREBV CERITIFV THAT I HAVE READ AND EXAMINED THIS APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDIYACES OVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH VVHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING Of A PERM1IIT S�OT PRESUME TO GIVE AUTHqRIN TO VIOLATE OR CANCEL TME PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGULA G C UCTION OR THE PERFORMANCE OP CONSTRUCTION. THAT 1 AM AUTHORIZE�BY THE <br /> OWNER OF THIS�ROPER P THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTR 0�{6�LAW 18 .200)A'AC. <br /> iJ / ; . <br /> ;, . �-�<<� , 3 ��, <br /> na ur of Owner ContracrodAu ed Agent ate �/ <br /> DEBIT 8 CREDIT CARDS ARE N07 ACCEPTED � <br />