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( <br /> P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SIJ��O Q SC I.^S� PARCEL TAX I.D.N PER�iT a �7- ��, / <br /> L � �`Y I I���U� `f <br /> LEGA LOTNO. BLOCK TRAC7 T <br /> DESC. <br /> OWNER ADDRE93 ZIP PHONE <br /> �-� r���r� zNo� c��� �,-t�� ���, r� 3�-�� <br /> TENANTNAME C TACTFORPhRMiT PHONE <br /> � ��`'�c r��( {— 9 g7-ol <br /> CONTRACTOR • ADORE39 ZIP CONTR.LICENSE M � <br /> �� �LI.YY�'t-Q�'O�"l <br /> PHONE <br /> PROPOSED USE OF BUILDING Buitding Mechanical Atldltion HEAT SOURCE <br /> PERMIT � COmbination R Plumbing WORK B Alleratlon I I7 ElecVlc <br /> TYPE Demolillon � Sign TMPE g Repair/Malnt. B o�,a, <br /> ��� Sprinkler <br /> CONTRACT PRICE OF WORK 3�� CITY OF EVERETf LOCAL SALES TAIC CODE IS 3705 <br /> WORK DESCRIPTION <br /> �a'1`'�l < <Q �o�-� y , � S f%t2v�Q C�. <br /> lC <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET(TOILET) A/C—AIHANDLING UNITS <br /> BATHTUB � FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAi PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY � WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URIN�L FIREPLACE INSERT <br /> DRINKING FOUNTAIN � GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER � GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBV CERITIFV THAT I HAVE READ AND EkAMINED 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 GNE AUTHORITI'TO VIOLATE OR CANCEL THE PROVISION OF ANV OTMER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHOR12ED BY THE <br /> O'.NNER OF TMIS PROPERTV TO PERFORM THE WORN FOR WHICH APPLICATION IS MADE AND i COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1d.27 RCW AND 296.200 WAC. <br /> /��t ���,z �,c�— �/�z.�v� <br /> Signature ol Owner/ContractoriAuthonzed Agant Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />� _- - <br />