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I � P�RMIT APPLICATIr"N <br />i CITY OF EVERETT PERMIT SERVICES <br />, 3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8&57 <br />I SITE ADORESS <br />I � � i� � <br />!i LcGALf LOT N0. <br />i DESC.� <br />BLOCK <br />TRACT <br />PARCEL TAX I.D. # <br />PERMIT # <br />�'_ c77S' 1 b <br />I TENANT NAME CONTACT FOR PER�dIT PHONE <br />' 1�;�i-� �c�mero. 'U�-tr�^� ���IIG a�3 �15a 1v5��q � <br />��� CONTRACTOR � . A�DR�SS, ZIP CONTR. LICENSE # '. <br />5i��1- I�C1� C 1e�4�i �� 3?���� �t4��n �ue �1'-ooc:� <br />I [ � .� 51 � NTC L�i `r�1 1 I <br />. PHONE `C'C ��� U�� 1 v�' <br />� `�2�'J�.'� ��J`d LG�..�Jq <br />PROPOSED USE OF BUILDING Building � 61echanical Addition HEATSOURCE � <br />PERMIT R COmbination Plumbing WORK �Alteralion � Electric '� <br />TYPE Q Demolition Sign nPE New Gas � <br />U Sprinkler RepaidP9aint. Other <br />CONTRACT PRIC[ OF WORK �� <br />��i,l WORKDESCRIPTION \,n�,��11 � ���I_� CF C+hL1Y1nQI 1�t���� `..7�L�'(��j. I <br />T <br />IqTY OF EVERETT LOCAL SALES TAX CODE IS 3'I05 �,I <br />PLUMBING <br />; NO. I TYPE OF FIXTURE OR ITE�d <br />IVATER CLOSET (TOILET) <br />BATHTUB <br />' LAVATORY (WASI' BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISFOSAL <br />DISH1h'ASHER <br />LAUNDRY TRAY <br />CL07HES WASHER <br />URINAL <br />DRINKING FUUNTA:iJ <br />FLOOR DRAIN <br />BACKFLO\V FREVENTER <br />_i SINK (SERVICe BAR?dCP;ETC.) <br />_� pTHER <br />� <br />mt�nAr <br />TYPE OF FIXTURE OR ITEM <br />A/C — NHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLPCElSTOVE <br />FIREPLACEINSERT <br />GAS FIREP�ACE <br />GASRANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER_ <br />i HEREBY CERITIFY TH4T I H.'rVc REP.D AND e41AiINED THIS APPLICHTION AND KNOW THE SA61E TO BE TRUE i+ND CORReCT. ALL <br />PROVISIONS OF LAWS AND ORIDINACcS GOVERNING THIS Tl'P� OF 11'ORK IVILL BE COh1PL1ED \NITH WHETHER SPECIFIED HEREIN OR <br />NOT, THc GRANTING OF:� PERA4IT DCES NOT PRcSUA1E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISiON OF ANY OTHER <br />STATE OR LOCAL L:.1V REGULaTING CONSTRUC7�pN OR THE PERFORA1ANC� OF CONSTRUCTION. THAT I Atd AUTHORIZED BV THE <br />01NNER OF TNIS PROPERTY TO PERFORM THE WORK FOR \1�HICH APPLICATION IS MADE AND I COMPLY WITH TH'c STATE <br />"GNTqACTORS LAIN 18.27 FCIY AND 296.2001NAC. <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />r-- <br />