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P�RMIT APPLICATII�iV <br />CITY OF EVERE�T PERMIT SERVICES <br />3200 CEDAR STREET, EVERE'I�', WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />DC� Gza.?-oi6 <br />SIT�7 RS� ��ek'� Ti i9%�� (,�/A� �(9 �� 2 A�i. 0.�.�0 `i� I PEXIN_f�� —(3/�� <br />LOT N0. I BLOCK I TRACT <br />POD�/t.fur� P110% .5�� S'or Gsvt/�'cT� �y/��FC/ �v/a- 7`ZOt �iaS3'S'J 8'ydr� <br />TENANT NAME CONTACT NAME PI10NE <br />�ff ° �n %� �2o7���f <br />CONTRACTOR <br />PHONE �%On��?S� <br />,C, U <br />��uitiD�rl1 <br />PROPOSED USE OF BUILOING <br />CONTRACT PRICE OF WORK f <br />WORK DESCRIPTION <br />ADDRESS <br />Building (((��� Mechanical <br />PERMIT R Combination j� Plumbing <br />TYPE D Defiolilion D Sign <br />U Sprinkler <br />n _pG� 1f f7"'7ff .��'n <br />`�f(/L <br />NO. � TYPE OF FIXTURE OR ITEM <br />Z WATER CLOSET <br />BATHTUB <br />7i 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 (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />LP CONTR. LICENSE A <br />���� ni'�z�z�z <br />RAdditian I HEAT SOURCE <br />Alteralfon n Eleclric <br />BNew ❑ Gas <br />Repair/Maint. � Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />NO. � TYPE OF FIXTURE OR REM <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 FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFiRECT. ALL <br />PROV�SIONS OF L4W5 AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PFOPEATY TO PEPFORtA THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTfjACT0�8.27 RCy�ND 296200 WAC. �' �� Q� <br />•�J �e� <br />