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�� <br />PERMIT APPLICATION <br />CITI' OF EVERETT PEHMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS I PARCEL TAX I.D. R <br />��2 / L_ � �/s� � c� �� r ✓£_ <br />LEGALJ LOTNO. I BIOCK I TRPC7 <br />DESC.r <br />PEFMIT u <br />�o���- ol�- <br />ur YlIVIVC <br />if',�/ �L✓f�/,.S£/J ?Z 2�/ L,a�2 £� ,�2 �BZo/ Yz� =zs2 -,� �� 6 <br />TENANT NAME I CONTACT NAME <br />PHONE <br />CONTRACTOR <br />C��Z <br />PHONE <br />��-yJVC�-� G�,'is <br />� � / S cIi✓i✓ y.�/!7 � <br />PROPOSED USE OF BUILOING <br />V �� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />ADDRESS <br />Sf1L f/iC � <br />,6 /vc�. S_� <br />ZIP CONTR. LICENSE N <br />�u�e�; T 98zos <br />Building Mechanical <br />PERMIT Combination �plumbing <br />TYPE Demolilion Sign <br />Sprinkler <br />�s O G <br />��F°L<!�`f � ( L FL12✓.dCL <br />NO. I TyPE OF FIXTURE OR ITEM <br />wA I tN GLOSET <br />BATHTUB <br />_ LAVATORY(WASH BASIN) <br />_ SHOWER <br />__ KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />_ LAUNDRYTRAY <br />_ CLOTHES WASHER <br />URINAL <br />DRINKING FOUN7AIN <br />_ FLOOR DRAIN <br />BACKFLOW PREVENTER <br />_ SINK (SERVICE�BAR/pdOP/ETC.) <br />_ OTHER <br />�Addilian I HEATSOURCE <br />Allerelion Electric <br />New Gas <br />RepairRAaint. Other <br />CITY OF EVEREfT LOCAL SALES TA% CO�E IS 3105 <br />W i � i-/ �ATc/��L Gi•4.f <br />N0. I TYpE OF FIXTURE Oq ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOT'-iE5 DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSEfiT <br />GAS FIREPLACE <br />GAS FANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER_ <br />1 HEREBY CERITIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TC BE TRUE AND CORRECT. ALL <br />PROVISIONS OF IJ�WS ANp ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br />NOT. THE GRANTIfJG OF h PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOL4TE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TFiAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK POR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON�PS L�PyG!-}B:Yj qCW AND 296.200 WAC. <br />