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� <br />( <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITEADDR[SS 6Cf(� �'��6(�E <br />w rt`�' <br />LEGAL LOT NO. BLOCK <br />DESC. II <br />OWNER <br />��� iNVEsrrtErvts <br />TENANTNAME <br />seeu�� iN <br />PARCEL TAX I.D. # <br />NOj' �,�JOW N <br />TRACT <br />ST <br />CONTACTFO/2P�RM1T � <br />� DhUID �IPSoN <br />CbNTRACTOR � <br />(,Op�TUNF, CONT2f+cC.-�Op� <br />PI10NE <br />3�00 � 8 62- 8 31 G <br />PROPOSED USE OF BUILniur. <br />D��lf..� �. CftP� <br />�Ns��c.r�oN �ys <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAV�TORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BARIMOP/ETC.) <br />OTHER <br />PERMIT <br />Tl'PE <br />PERiv11T d <br />�e <br />98zn� C4L5) 3�E8-12.�y <br />PHONE <br />C4 Z5j 3�F8- I <br />ADORESS ZIP CONTR.LICENSE# <br />i4co glc.��ov.� �u6.��24 I cAesTc�.9�4k.� <br />srvottoMiSH , w� <br />Buildi0g Methanit3l Addilion HEAT SOURCE <br />Combinalion Plumbing wORK RAltention Eiearic <br />Demolition � Sign TYPE B New RI�c,s <br />Sprink�er Repair/Mainl. LJ Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />IMP�OvEM�NT <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/G — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HE�T PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGF HOOD <br />WATER HEATER <br />MET�L FIREPLACE/STOVE <br />FIREPLACE INSERT <br />Gl1S FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ �ND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL <br />PROVISIONS OF LAWS �ND ORIDINACES GOVERNING THIS iYPE 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 />SLTATE OR LOCAL L�W REGULATING CONSTRUCTION OR THE PERFORA9ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />�HER.QF THIS P OPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPIY WITH THE STATE <br />COI�ITRAC7'O�S LA�8,27 RCW AND 296.200 WAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />