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. , <br />FcRMIT APPLICATI�,►N <br />CITY OF EVERETT PERMIT SERVICCS <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS <br />,—. �� _ <br />�_ ii -�� ,� s i^ _ . ,.— <br />LEGAL LOT NO. BLOCK <br />� � <br />DESG. ` j./-, '/'r'��.j_I <br />� — ' 1" ✓, <br />_ -� � , ,- ��. '. r -, <br />�, <br />TENANTNAME <br />CONTRACTOR <br />PHONE <br />PROPOSED USE OF BUIL�ING <br />�-�` -'�'-�' _ <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />Q� G�— t <br />TRACT \ <br />`._,�::� �P �' �_,� �� \ <br />'�-� — l,.-._ 5� <br />{.. % � �) �r7Y � __ -(-�- -�-- <br />� <br />NO. I TYPE OF FIXTURE OR ITEM <br />CONTACT FOR PERMIT <br />� \ �`.,' , <br />ADDRESS <br />Building Mechanical <br />PERMIT Combinalion � Plumbing <br />TYPE Demolition Sign <br />Sprinkler <br />( ! <br />���~ <br />j1��_.! ` '—_ <br />WATER CLOSET (TOILET) <br />BATHTJB <br />LAVATORY (WASH BASIN) <br />SHOW[R <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKiNG FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />�E <br />ZIP <br />PERIv11T n <br />,� , � � <br />^, ,i� <br />��'r., <br />�—� !'� <br />CONTR. LICENSE # <br />���� <br />Addition <br />Altera6on <br />New <br />Repair/Mainl. <br />HEATSOURCE <br />Electric <br />Gas <br />Othei <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� - � I ��. :--�3��i <br />�_� Y` � � <br />� i � —`.r.�- ':4"��-_ <br />MECHAP <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />bVATER HEATER <br />MEl'AL FIREPLACF/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />� EXHAUSTFAN <br />OTHER <br />� <br />, I HEREBY CERITIFY THAT I HAVE READ AND EXAMINFD THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIGNS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />: NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />: STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />IOWNER OF THIS PROPERJYso.PERFORM1I THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS lAW 18.77 RCyy-A�1�.�96.2� WAC. � / <br />DEB!T & CREDIT CARDS AR� NOT ACCEPTED <br />l�Z <br />