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"ERMIT APPLICA7- DN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />rAh�CL I AA I , # PERMIT # <br />LEGA LOT NO. BLOCK TRACT <br />DESC. Y] 6 <br />OWNER ADDRESS <br />ZIP PHONE <br />AIEb M AL k d 1 o r �� l►'I A2 l'k) UI EcJ �12 0Z7S +2-5 �7 va�3 <br />TENANT NArd CONTACT NAME PHONE <br />io.A <br />CONTRACTOR OG(.)A/ C L ADDRESS (,ZIP CONTR. LICENSE # <br />PHO 4,� ' 700 b37 <br />PROPOSED USE OF BUILDING <br />PERMIT R <br />TYPE <br />I <br />BUllding <br />Combination <br />Demolition <br />D Mechanical <br />U PlUmbing <br />U Sign <br />WORK <br />TYPE <br />Addition <br />N Allerallon <br />New <br />HEAT SOURCE <br />I j� Electric <br />Gas <br />Sprinkler <br />Repair/Maint. <br />B Other <br />CONTRACT PRICE OF WORK l �D fir) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 310S <br />WORK DESCRIPTION 6�IGJ, r�� <br />� C'�/4 <br />�LV6 1 <br />OT W„�Ge <br />p���� <br />a �iO►ZA tiJ!cJ <br />wtTH <br />SA�41,6 <br />clAPA Ct�Tt7 <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <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 />OTHER SINK ERVICE BAR/MOP/ETC.) <br />_ <br />_ <br />— <br />— <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 />OTHERST A� N r r ru <br />_ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIOINACES GOVERNING THIS TYPE OF WORK WILL 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 />jN <br />F THIS PROPERTY TO PEZRF RM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />2V <br />CTORS 96.200'NAC. <br />- ���0Z <br />