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� <br />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 />LE L TNO. <br />DESC. <br />Ta � n� <br />TENANTNAME <br />CONTRACTOR (�J'� _ <br />PHONE <br />PROPOSED USE OF BUILDING <br />S��V•�ln.��.l� d�as <br />BLOCK I �CT <br />CONTRACT PRICE OF WORK NIA _ <br />PARCEL TAX I.D. N <br />CONTACT FOR PERMIT <br />(�a,.�.-� �-t�.�s <br />ADDRE3S <br />Building Mechanical <br />PERMIT � COmbinetion � PlUmbing <br />7YPE Demolition Sign <br />Sprinkler <br />b3 -0 j �— <br />�..�.+,1sZo� 4�t53 <br />PHONE <br />�2.5 �i 3" lo� � S <br />ZIP CONTR.LICENSER <br />Addition HEATSOURCE <br />WORK terah � <br />TYPE New � Gas <br />RepairlMaiM. Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br />WORK DESCRIPTION ��.��� <br />��' 3�t� ��. �Fe.ci ��-(��c5 io ga..y�, (ta�'�S�hr.� S�ou4r-� VS,ti� 2.X'T7fn�.� <br />�i:t;-4, a,^c�. CEto.�..i F«r.aa.-l-eor., wck.- so�co.. al.�co.a� -N.�n..�). <br />NO. I TYPE OF FIXTURE OR 17EM <br />WATER CLOSET <br />BATHTUB <br />� LAVATORY(WASH BASIN) <br />� SHOVJER <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 (SERVICEIBAR/MOP/ETC.) <br />OTHER <br />� Yo� lc 1' <br />NO. I TYPE OF FI%NRE OR ITEM <br />A/C-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 />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND FJ(AMINED THIS APPLICATION AND KNOW 1HE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE Of WORK WILL BE COMPLIED VNTH WHETHFR SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLA�f E OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CUNSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR2ED BY THE <br />OWNER OF TNIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS L9W 18.2��W AND 29jLl00 WAC. <br />_/� .� / L _ � . . <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />'�a <br />