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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS <br />l821 NiGH[.AN�� <br />LEG LOT NO. OLOCK <br />DESC. S -f �j �s3 <br />PARCEL TAX I.D. • <br />�S63Z3S�oo <br />TRACT <br />5% /t%�G.I�oL/1 <br />C <br />SAM FR-iULSo�-1 It�LI N14�ILqNO AJ. `1t5'•2Sq-N3tL <br />7ENANTNAME I CONTACTNAME PHONE <br />� Sqn�r - JASar� MA�o� yZs-3y�/- 4Sio <br />CONMACTOIt <br />F�►��s�l <br />PHONE <br />N2S- 3� <br />ADDRESS <br />� iN�: s C��sr',r.,��. <br />PROPOSED USE OF BUIIDIN6 <br />S F�Z <br />/L <br />6R��� 72r°s•—N� <br />�Building DMechenical <br />PERMIT Combinetian B Plumbing <br />7YpE Demolition Sign <br />Spinkler <br />CONTRIICTPRICEOFWORK �I�ZOO � <br />WORK DESCRIPTION <br />�.�Ft.AGT�Jk A Co�2�zJt.�ri0 <br />$TAJi.TJ�2� UO TC Lo. �� <br />NO. � TYPE OF flXTURE OR REM <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 (SERVICE/BARIMOP/ETC.) <br />OTHER <br />nr coNrn. uc�eE � <br />F,Nrs�c �i66�t <br />9<4i7o <br />Ad�Nion <br />Alteretla� <br />New <br />RapehlMaint. <br />HEAT 8011RCE <br />� ENeMc <br />Gea <br />omer <br />CtfY OF EVERETT LOCAL SALES TAX CODE IS ]703 <br />RGt�} �RTTG CJJs�./(_ � I,JIL�w%l.�1�J� <br />NO. I TYPE OF FlXTURE OR REM <br />AIC — AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER MEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND E%AMINED THIS APPLICATION MD KNOW THE SAA�E TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL 8E COMPLIED WITH WIETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTMER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTFIORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM TME WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />