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� <br />SITE ADDRESS <br />il) Y✓1� <br />��= �-a <br />TENANTNAME <br />��RMIT APPLIC�►TI(:,�� <br />CITY OF EVERETT PERMiT SEFiVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8A57 <br />CONTRAO tn,� �.1 C� � �I •.-r.w � �� <br />PHONE zo�32 i �� � <br />PROPOSED USE OF BUILDING <br />� � Y`��.c+{+ <br />CONTACTNAME <br />PERMIT q <br />M c�zo 3 -oz <br />PHONE <br />ADORESS LP CONTR. LICENSE N <br />�(o�� Dcl�:�,e �SI..�Sc4��c q$/C�G <br />,�ou�ryw�o��c6 <br />n Building � Mechanicai <br />PERMIT r-S Combinalion Plum6ing <br />7vPE �� Demolilion Sign <br />D Sprinkler <br />Addition I HEAT SOURCE <br />WORK � Alleration � Electric <br />7YPE New Gas <br />Repair/MainL Uther <br />CONTRACT PRICE OF WORK �' �-' �� I CITY OF EVEREl7 LOCAL S4LES TAX CO�E IS �705 <br />WORK DESCflIPTION <br />�e� ��e C� g�s l,J 0�"�- ��0`� � <br />� <br />r <br />NO. � TYPE OF FIXTUFE OR ITEM <br />WATER CIOSET <br />_ BATHTUB <br />_ LAVATORY (WASH BASIN) <br />_ SHOWER <br />KITCHEN SINK 8 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 W a-'�e/ I�¢n±�-�.�- <br />NO. � TYPE OF FIXTURE OR fTEM <br />A/C - A/HANDLING UNITS <br />FORC[D AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPIACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE REA� AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO DE TRUE AND CORRECT, ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY QTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION Oq THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OW�JER OF THIS PROPERTY 70 PERFORM THE WORK FOR WHICH APPLICATION IS MADE AN� I COMPLY W�TH THE STAT= <br />CONTRACTORS LA�(J 18.2J RCW AND 296.200 WAC. <br />