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� <br />� <br />IT APPLICA' <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />sRe aooaess da a 3 F, rla h d P1- <br />Eu�r��i bc��. 9 8.Zo3_ <br />DESC. I I <br />OWNER '5�.�.� +� G�„„Y <br />(,t%ooQ 1�oc.�sc <br />TENANT NAME <br />CONTRACTOR � Ja ( ba�� �n� <br />PHONE L%v2S-�`SeZ' %ySa <br />PROPOSED USE OF BUILDING I pERMIT <br />���� r�N� TYPE <br />� <br />PARCEL TAX I.D. • <br />pp Soo 6 00 000700 <br />,2a'��3 Fr iw nci iL . <br />CONTACT NAME <br />PERMIT N <br />Y��CD� ���o <br />N2S- <br />—oNE <br />PHONE <br />ADDRESS a�3� ��S�I�N� AUC. CONTR.LICENSEN <br />L'�v�rc'f{ � !.C%rn• 9g�� % NAL�SAc��3ooN <br />Building n Mechanical n Addition HEAT SOURCE <br />�Combination ❑ Plumbing WORK �'�1 niteration �E�� <br />Demolition � Sign TYPE C� New 68$ <br />Sprinkler Pf RepairlMeint. �e� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION ��,�� e� �� �,y� �� ({ e I <br />NO. I TYPE OF FlXTURE OR fTEM <br />WATER CLOSET <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 �7RAIN <br />BACKFLOW PREVENSER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />CRY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />NO. I '1YPE OF Fl%TURE OR ITEM <br />A/C-A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYEH � C�O H4M� J <br />RANGE HOOD� <br />WATER HEATER <br />METAL FIREPLACE/STOVr <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREOY CERITIFY THAT I HAVE READ AND EXAM�NED 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 SPEC�FIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PfiOVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTIO�: OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOfl WHICH APPLICATION IS MADE AND I COMPLY WITH TME STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />�' <br />`;'-(.l-� <br />