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SITE ADDRESS <br />�or Nu. <br />TEN4NTNAME <br />N/� <br />PERMIT APPLICATION <br />GITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf ' UA 98201 <br />425-257-8810 — FAX 425-257- .857 <br />PARCEL TAX I.D. N <br />��(�000c <br />�L�OcrCfK TRACT <br />W —�� I lin A <br />N /!` <br />P� I « ' O r <br />PEFMIT M <br />�/ 1 ��-U^7- <br />PHONE <br />I 1�Zs� 4Zs.��t <br />PHONE <br />CONTRACTOR A�DRESS ZIP CONTR. LICENSE 1 <br />PHONE J�� ('.•Z�,.••l� �� GoNi�. SA�Nc I.s Ainuc • .S �iC,1�../tL7!'UIIA/�, <br />PROPOSED USE OF BUILDINO <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />�,.'. lc� A <br />Building Mechanical <br />PERMIT Combinalion � Plumbing <br />TYPE Demolillon Slgn <br />Sprinkler <br />�'C�� . <br />� � � � � SFi2 . <br />� �da,�t. � i �s <br />NO. � TYPE OF FIXTURE OR REM <br />WATER CLOSET <br />BATHTUB <br />LAVATOt;Y (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKI^iG FOUNTAIN <br />FLGOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHCR <br />n Addilion <br />��S Alleration <br />� �New <br />Ll RepeldMalnt. <br />HEATSOURCE <br />�Elecirk <br />Oas <br />Olher <br />CITY OF EVERETT LUCAL SALES TAX CODE IS 3105 <br />NO. � TYPE OF flIfTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL F;9EPLACE/STOVE <br />FIREPLACE INSERT <br />OAS FIREPLACE <br />GAS RANOE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CEfiiTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAMF TO BE TRUE AND COFif1ECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS TVPE OF WORK WILL BE COMPLIED WITH WHETIIER SPE�:IFIED HEREIN OR <br />NOT. iHE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PFOVI517N OF ANY OiHCR <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTH091ZED BY THE <br />OWNER OF TIiIS PfiOPER7Y TO PERFORM THE WOHK FOfl'NHICH APPLICATION IS MADE AND I COMPLY WITH THE ST.1i E <br />CONTRACTORS LAW 18.2�W AND �9620p WAC. <br />