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� <br />LOT N0. <br />TENANTNAME <br />�oN���N <br />PHONE � <br />Fl -RMIT APPLIGATI��.�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-887 0 — FAX 425-257-8857 <br />Wi% <br />6LOCK <br />PARCEL TAX I.D. # <br />PERPAIT k <br />�Y'`p <br />— _ I CONTACT NAME � �� � NE <br />VO(Gf�$(KdM; S�VIA � � �, Qq,,�8 <br />� ADDRESS ZIP CONTR. LICENSE N <br />+b' 394� W . �f��k'E' bR., 6US�+pFI�C5 (.�i <br />5396 So JOkb�J . �r f�� <br />PROPOSED USE OF BUILDING I Building D Mechanical D Addition HEAT SOURCE <br />PERMIT Combination U Plumbing WORK � Alteralion Electric <br />TYPE Demolition U Sign TYPE New Gas <br />__ Sprinkier RepaiAMaini. Other <br />CONTRACT PRiCE OF IVORK r f� w�/� i CITY OF EVERETT LOCAL SALES TAX COGE IS 3105 <br />1 �/VW <br />WORK DESCRIPTION /►I>�� w` �,�' O� NG , J '`S� �`���) lw) �� <br />�GH� s M I(,A'(y CQuPM�IT�'i�. R��O CEl 1.�� , <br />5 _ <br />NO. I TYPE OF FIXTUqE OR REM <br />_ WAl'ER CLOSET <br />_ BATHTUB <br />LAVATORY (WASH BASIN) <br />SHUWER <br />_ KITCHEN SINK 8 DISPOSAL <br />_ DISHWASHER <br />_ LAUNDRY TRAY <br />_ CLOTHES WASHER <br />_ URINAL <br />_ DRINKING FOUNTAIN <br />_ FLOOR DRAIN <br />_ BACKFLOW PREVENTEF <br />_ SINK (SERVICE/BAR/MOP/ETC.) <br />_ OTHER <br />N0. � TYPE OF FIXTURE OR REM <br />_ �vc:—A/HANDLINGUNITS <br />_ FORCED Alfl SYSTEMS <br />._ HEAT PUMP <br />_ UNIT HEATERS <br />_ CLOTHES DRYER <br />_ RANGE HOOD <br />_ WATER HEATER <br />_ METAL FIREPLACE/STOVE <br />_ FIREPL/:CE INSERT <br />_ GAS FIREPLACE <br />_ GAS AANGE <br />_, GAS PIPING <br />_ EXHAUST FAN <br />__ OTHER <br />I HEREBY CERITIFY THAT I HAVE REA� AND EXAMINED THIS APPLICATION ANU KNOW THE SAME TO 6E TRUE AND CORRECT. ALL <br />PROV�SIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE7HER SPECIFIED HEREIN OA <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW qEGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWN O HIS PROPERTY TO➢GCEORM� WORK FOR WHICH APPLICATION IF. MADE AND I COMPLY WITH THE STATE <br />r.oN ar.r ¢ i ew �ab> or�nd�un�f��., <br />�L <br />