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P�RMIT APPLICATION <br />CITY OF EVERETT PEFcMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25'i-8810 - FAX 425-257-8857 <br />SITE ADORESS <br />��PO FuPr�:�-P�'/r� �/� <br />LEGA LOT N0. BLOCK <br />DESC. <br />OWNER <br />y v `�'�,� r.�/�y� <br />TENANTNAME <br />,�_ G /�� ��� � <br />CONTRACTOR �' <br />�/ �it/ Pu�" <br />PHONE <br />��.�' s�3_ <br />PROPOSED USE OF BUILDING <br />y�- r �Ot/y^JL'- <br />CONTRACT PRICE OF WORK <br />PARCEL TAX I.D. # <br />TRACT <br />soo.r 5���� <br />CONTACTFORPERMIT <br />ADDRESS <br />PEriMIT # <br />L�..'�✓e <br />�/ <br />wk `i��,S-%3N�94v <br />� co/ ��S- 330 - /8's-3 <br />Buiiding Q Mechanical <br />PERMI7 �Combination �] Plumbing <br />7vPE Demolition L� Sign <br />Sprinkler <br />WORKDESCRIPTIONI� �'jJTj F/ �ij",.j-�l.^u��--� <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />TAVATURY (WASH BAS�N) <br />& DISPOSAL <br />LAUNDRYTRA <br />CLOTHES WASH <br />UR�NAL <br />DP.INKING FOUNTAIN <br />FLOOR DRAIN <br />BACI«LOW PREVENTER <br />SINK (SERVICE/BAR/MOP/E <br />OTHER <br />ZIP CONTR. LICENSE # <br />�Addilion <br />Alleration <br />New <br />Repair/Maint. <br />HEATSOURCE <br />ElecVic <br />Gas <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 37�5 <br />N0. I TYF[ OF FIXNRE OR ITEM <br />A/C-AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLUTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />'CAS PIPING <br />EiCHAUST FAN <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINEL' THIS APPLICATION AND KNOW THE SAME T�E TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERhiNG THIS TYPE OF WORK WILL BE COMPLIED WITH HETHER SPECIFIED HEREIN OR <br />NOT. TFiE GRANTING OF A PERMIT DOES NOT''Rr_S'�IvIE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRU�'��ON OR THE FERFORM�NCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE'NORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27BCV� AND 296200 WAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />