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PIRMIT 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 PARCEL TAX I.D. N PERMIT 9 <br />S .&U,pu \ S 0 I 6,401-D3q <br />LEGA LOT NO. U BLO K TRACT <br />OESC.I <br />OWNER ADDRESS ZIP PHONE <br />by , U.Ac. S (?",AV Qh � <br />TENANT NAME I CONTACT FOR OGIJMIT PHONE <br />CONTRAC OR a /Y4` \ aft`�I ADDRESS ZIP( CCONTR.'LIICCEN\SIE`N <br />PHONE <br />PROPOSED USE OF BUILDING I fi Building Plumbing f� Addition HEAT SOURCE <br />� PERMIT I�KU(t Combination Plumbing WORK 1`rL�j�(X Allera0on �LFRU-/{Electric <br />TYPE Demolition Sign TYPE New Gas <br />Sprinkler RepairlMaint. Other <br />CONTRACT PRICE OF WORK I Q CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION r <br />�j c1, �L�O Q�- U 1 0•,� ✓ iS vl 1 tUl , <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPIETC.) <br />OTHER <br />= <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />OAS PIPING <br />EXHAUST FAN <br />OTHER <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />I HEREBY CERITIFY THAT 1 HAVE READ AND EXAMINED 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 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STA7F, OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OW E OFLTFjIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />c0 CTpFV LAYJ l8.27 RCW AND 296.200 WAC. I <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />