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PERMIT APPLICATION <br />ClTY QF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE AODRESS <br />l o i���- <br />LE L LOT NO. BLOCK <br />DESC. <br />OWNER <br />���\F. �Unsoh <br />TENANTNAME <br />CONTRACTOR <br />F� <br />�� �o„S�'r���wn .�udKes <br />_ -� � ��� - �iyo <br />PROPOSED USE OF BUILD�NG � <br />/ PERMIT <br />rS/plPislCiG TYPE <br />CONTRACT PRICE ElF WORK <br />PARCEL TAX I.D. # <br />:kACT <br />ADDRESS <br />�� 3�'' f,, ✓� � <br />CONTACT F0;4 PERMIT <br />�� /% <br />n� �G°M�'r1P� <br />ADDR S <br />�OQ�X 1Aa.s� <br />�� un�" v�nrn (itl� <br />�Building p� Mechanicai <br />Combination f� Plumbing <br />Demolition D Sign <br />Sprinkler <br />P�D�-� <br />ZIP PHONE <br />l�„�,�/ 9�25��33v l �, <br />" PNONC <br />3GD 2�'/-G/y <br />ZIP C:1NTR. LICENSE if <br />Aw2�o; �� <br />4�2�3 <br />AddiUon <br />WORK Alte�ation <br />TYPE r;ew <br />J Repair/Maint. <br />HEATSOURCE <br />lectnc <br />Gas <br />Olhe� <br />CITY OF EVER�TT LOi.AL SALES TAX CODE IS 3105 <br />WORKDESCRIPTION n�.� 1]oU� 'l'� OVU fjySt 'N%T -�"oi <br />lL r7 <br />�/"�,sr"�.,�'F`v,-�,� a����� �y��,`�o���,�y <br />N0. � TYPE OF FIXTURE OR ITEM <br />� <br />WATER CLCSET (TOILET) <br />BATHTUB <br />LAVATGRY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />UP.IfdAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PRF'JENTER <br />SINK (SERVICe/BAR/MOP/ETC.) <br />N[u Scr� <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 />= WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />= GAS PIPING <br />� EXHAUST FAN <br />_ OTHER _ <br />i/ <br />I HEREBY CERITIFY THAY I HAVE READ AND �XAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OR�DINACES GOVERNING THIS TYPE OF 1VORK WILL BE COMPLIED WITH WHETNER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DO S NOT PRESUME TO GIVE AU7'HORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />ST.4TE OR LOCAL LAW REGULATING NSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I r".M AUTHORIZE� BY THE <br />ON'NER OF TFFF}}}���S P OPERTY TO PERF Rh1 THE WORK FOR WHICH AFPLICATION IS MADE AND I COMPLY WI7H THE STATE <br />CCNTRACTOPoS�27 RCW AND 96.200 WAC. �/ /O� <br />�� ., (� , in <br />'/L <br />DEF31T & CREDIT CARDS ARE NOT ACCEPTED <br />