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� <br />� <br />PE�3MIT APPLICATI <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98207 <br />425-257•8810 - FAX 425-257-8857 <br />SITE ADDRESS (e /'S � Qyc�� I PARCEL TAX I.D.1 I NERM�T M __ <br />LOT NO. <br />TENAM NAME <br />COHTRACTOR <br />PHONE ��S as9�Y'4�y <br />r <br />PROPOSED USE OF BUILDING <br />.C�F(� <br />BLOCK I TRACT <br />ADDFE53 <br />� lo/S L�'"_� w' ` <br />ICONTACTNAME <br />/ � ADDRESS ✓� �� �r �, <br />r <br />�� �/. <br />I Building Mechanical <br />PERMIT R Combination � Plumbing <br />TYPE g Demolilion Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK y� a J� <br />�. <br />. <br />�070.3 <br />PHONE <br />CONTR. LICENSE � <br />�EPE�I�vq o/G Kk <br />Addition <br />Alteretion <br />New <br />Hepair/Meint. <br />MEATSOURCE <br />�Electric <br />Gas <br />Other <br />CITV OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION f p 1 ,/^ <br />1 ( � L l r � L � (,U-� (/� ✓�%r r�L !� !/ �7 �-- <br />NO. I TYPE OF Fl%TURE OR REM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />�ISHWASHER <br />_ LAUNDRYTRAY <br />CIOTHES WASHER <br />_ URINAL <br />DRINKING FOUNTAIN <br />FLOOF DRAIN <br />_ BACKFLOW PREVENTER <br />SINK (SERVICE/8AR/MOP/ETC.) <br />_ OTHER <br />N0. � TYPE OF flXTURE OR ITEM <br />A!C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />_ HEAT PUMP <br />_ UNIT HEATERS <br />_ CLOTHES DRYEF <br />_ RANGEH000 <br />_ WATER HEATER <br />METAL FIREPLACEiSTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />'� GAS PIPING C� �G� �'�<e '�e p���htE a <br />_ EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE R'cAD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE AUTHORI7Y TO VIOLATE OH CANCEL TNE PROVISION OF ANY OTHER <br />STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWVER OF THIS OPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACjOR W iB.�.7�ACW AND 296.200 WAC. <br />� � �- i�.�; �>) <br />