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� PERMIT APPLICA'�-ION <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 />LEGA LOTD <br />DESC. <br />�'G�.1�'e %9� <br />iENANTNAME <br />c� <br />CONTRACTOR <br />Le�S�r aP�e�'7 <br />PHONE <br />y1s"-33 y� <br />PARCEL TAX I.D. S <br />BLOCK � TRACT <br />CONTACT <br />or�ss <br />i//9-7S���v� S'� •Cv�r�f% 9��'0; Le�Cs�AY <br />PROPOSED USE OF BUILDING <br />4\t i, <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION p Yd� r <br />�� � <br />NO. � TYPE OF FI%TURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOW ER <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 />Building DMechanical <br />PERMIT � Combinatlon U Plumbing <br />7Ype Demolitlon U Sign <br />Sprinkler <br />PERMIT # <br />- iS � � <br />`� % S <br />PHONE <br />ys� �3% �/C�S <br />21P CONTR. LICENSE • <br />Csy.� �� <br />�Addltlon I NEAT SOURCE <br />Alteretlon [� ElecMc <br />� ❑ G8g <br />RepalrlMaint � Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3706 <br />����..�, <br />NO.. I 1YPE OF:FUITURE OR 17EM <br />AIC—A/HANDLING 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 />I HEREBY CER�TIFY THAT I HAVE READ AND E7(AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PkOVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED FiEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTf2UCTI0N OR THE PERFORMANCE OF CONSTR' 1CTION. THAT I AM AUTHORIZED BY TME <br />OWNER�THIS PROPERTYSQ P6RFORP.�THE WORK FOR WHICH APPLICATION IS MADE AWD I COMPLY WITH TNE STATE <br />nnu�o r noc i ew sfinuFC1N ATI� 298200 WAC. � <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />