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� <br />� <br />a <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 />PARCEL TAX I.D. # <br />LOT NO. I BLOCK <br />�.�v�,�i;i� �i�0��.c.,�-, �l� � �' � <br />TENANT NAME ��� �,� I� CONTACT FOR PERMIT <br />��YV� � e. I(�� <br />CONTRACTOR ADDRESS I'lI � � <br />�(riYYIGrCIo� r��ro-Itc�i� � '�l�i �C(�cX� <br />P��i� 8�1� �149 3 <br />PROPOSED USE OF BUILDING <br />��� <br />CONTRACT PRICE OF WORK 1(� <br />\! <br />WORK qES RIPTIO � <br />� �`�� �'L <br />sys � �� <br />PLUMBII� <br />NO. I TYPE OF FI%TURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (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 (SERVICEIBAR/MOP/ETC.) <br />OTHER <br />PERMIT # <br />�-10 ��i -�� � <br />' w�-q� iZZ <br />PHONE <br />31�� 8�f � Q(�3-c�� 122 <br />21P CONTR. LICENSE fl <br />UJ� q�Z73 �e�32 <br />Building DMechanical <br />PERMIT � Combination �j Plumbing WORY <br />7YPE Demolitian U Sign ivPe <br />Sprinkler <br />�� <br />Alteralion <br />New <br />RepairlMaint. <br />HEATSOURCE <br />n Eledric <br />B Gas <br />Other <br />CIN OF EVERETT LOCAL SALES TAX CODE IS a105 <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC — AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAVJS AND ORIDINACES GOVERNING THIS NPE 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 />STATE OR LOCAL IAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />ON�IE� OF THIS PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON7RAlCTO}'L$ LAy�118,271RCW qND 296200 WAC. , I <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />��2 <br />