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Ar <br />PERMIT APPLICATION <br />CITY OF EVEFIETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />42.5-257-8810 — FAX 425-257-8857 <br />II <br />SITE ADDRESS f',,, `^�-- /� PARCEL TAX I.D. # f jERMIT a <br />/1-10- %�_ i-v) 1 414,— I I L4Y1117_n1)i— <br />LEGA <br />LOT NO. <br />DESC. <br />OWNER <br />TENANT <br />NAME <br />BLOCK I TRACT <br />CONTACTNAME PHONE <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE p <br />PHONE <br />PROPOSED USE OF BUILDING I Building Mechanical I Addition HEAT SOURCE <br />PERMIT I Combination R Plumbing WORK R Alteration Electric <br />G�c� TYPE Demolition I Sign TYPE B Nev Gas <br />�j Sprinkler (d of heads) Repair/Mainl. Other <br />CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />01mDUrl- ow whPeGr 5whp-1 Gam', <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOII.Er) <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 <br />_ <br />_ <br />_ <br />ArC — AIHANDLING 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 />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <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 ORIDINACES 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 AUTHOFITY 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 />OWNER OF THIS OPERTY TO PERFOR THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STAT E <br />CONTRACTO 18.27 D . 00 <br />W <br />