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,f <br /> P r2MIT APPL�ICATIO�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT u <br /> �4g l�o �✓er-, t-eev� �G / Xovob -ooy <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER A�DRESS ZIP PHONE <br /> tJeti.� `�5�,-oye� �{s��g� E��.;y,-��e� �,✓�y q8-zv3 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> �n,.�\� 7e�}-roY��r `�ave �t'Yr�v�D�. Z� Co^ ��i0 - C7ES'O <br /> CONTRACTOR ADDRESS � ZIP CONTR.LICENSE# <br /> w�r. �,c�lrr '�lu�,..b'.�.ry.. I�Za ��W ib�`` Sw;�e 1� 3gc;'� w"RR�OP� Ozz,vE <br /> PHONE ('\Fvctv.�� w'A y �c�S� <br /> PROPOSED USE OF[3UIL�ING pERMIT B Sprink'leation � Plumb ng al W�RK B Repa r/Maint, HEAfT�,SE eRnE <br /> TYPE Dem0lition Sign TYPE New u Gas <br /> L� Other <br /> CONTRACT PRICE OF WORK r �/ ��� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION 1� ����\��� ��? Ja �-p g�.r uaw� S � 2 ,'LO$Q �'jlbs� � <br /> ��P.�OCD�j'Q "Je^�PC �Rrr�C'PI' GYIp� vIPL� v'(�.TPJ SPY✓\Ce <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. .I TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> 1 KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br />_ LAUNDRY TRAY = WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> � FLOOR DRAIN GAS RHNGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> 'L OTHER NaSQ S�bS OTHER <br /> I HEREBY CER:TIFY THAT I HAVE READ AND EX4MINE0 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 COh1PLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRAtJTING OF A PERMIT DOES NOT?RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION Or ANY OTHER <br /> STATE OR LOCAL LAW REGULATI�IG CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICAI'ION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AN 96.200 WAC. <br /> �,.tie4— � 6�7%a '� <br /> Signafure of OwnedContractor/Authorized Agent Dat <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED � <br />