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T <br />SITE ACDRESS <br />� �� L <br />LEGA LOT NO. <br />DESC. <br />PERMIT Ai�PLICATION <br />CITY OF EVERETT PERMI�' SERVICES <br />3200 CEDAR STREET, EVERETT, V'JA 98201 <br />425-257-8810 — FAX ;25-257-8857 <br />BLOCK � TRACT <br />PARCEL TAX I.D. # <br />�uFt.e11" �'ouS��C. �uT�ioei�i 31�-} Crot�U'� �-ve�rc�}' `i��-S��-Slsl, 1 <br />TENANT NAME CONTACT NAME PHONE <br />CONTRACTOR -.} ADDRESS <br />�L'��P! 11 f{LJ��S�'U(a �ut�/va�1`/ <br />PHONE <br />�Iz5-��1' Slal,i <br />PROPOSED USE OF BUIL�ING <br />SF�� <br />CONTRACT PRICE OF WORK <br />Iluilding �Mechanical <br />PERMIT R Combina�ion"�� Plumbing <br />TYPE � Demolition Sign <br />Sprinkler <br />WOFKDESCRIPTION ,.� �p�S�v�4qVev``�'�f�i <br />R2Mo�sQ � I <br />NO. � TYPE OF FIXTUFE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEBAR/MOP/E'fC.) <br />OTHER <br />ZIP CONTR. LICENSE M <br />Pddition HEAT SOURCE <br />WORK �Alteration � Electric <br />TYPE New Gas <br />RepaiUtdainl. Other <br />.CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEAAS <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 HEREBY CERITIF'i THAT I HAVE READ A�ID EYAMINED THIS APPLICATION AND KNOW THE SAM11E TO OE TRUE AND C�FRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES C;OVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEThER SPECIFIED HEREIV OR <br />NOT. THE GRaNTING OF A PERMIT DOES NOT PRESUh1E TO GIVE AUTHORIN TO V;OLATE OR CANCEL THE PFOVISION OF ANY Ol'HEfl <br />STATE OH LOCAL LAW REGULITING CONSTRUCTION OR THE PERFORMANCE OF CONS7�UCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS h1ADt AND I COMPLY WITH THE STATE <br />CONTRACTOfiS WW 1827 RG'N AND 296.200 WAC. <br />a/i,/oa <br />