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SITE ADDRESS <br />N0. <br />DESC.r •� <br />PtRMIT APPLIC/�►TIC��� <br />CITY OF EVERETT PERM!T SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />. 425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX I.D. b <br />C'C7f�R?�r"4! ,fli�''r� �-i�c li�'I'-1 �3�c/ �iSL 9k20�' �/�5 3i75�73 <br />TENANTNAME I CONTACTNAME PHONE <br />� <br />CONTRACTOR <br />�C�F_�'i zr�t, <br />PHONE <br />L( ��� � i% <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />. / ADDRESS 21P CONTR. LICENSE # <br />�f�fC '%•c ji��/ 25��/%�7 9�u+� Gc��=.�TNio�`�co <br />C4�+t i��� �� � <br />[�"'�uilding Mechanical <br />PERMIT � ) Gombination � Plumbing <br />TYPE D Demolition Sign <br />U Sprinkler <br />G ! ��-�. A Ji � G4 c �(,��-�-CG <br />NO. I TYPE OF FIX'TURE OR I7EM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAFi/MOP/ETC.) <br />OTHER <br />d <br />Addition <br />Alteration <br />ew <br />Repair/Maint. <br />HEATSOURCE <br />Eleclric <br />as <br />Other <br />CITY OF EVERETC LOCAL SALES TAX CODE IS 3105 <br />,,�.�.c� 2Z35 <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIF;EPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY C6RITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PFOVISIONS OF LAWS AND OFIDINACES GOVERNING THIS TYPE OF WORK bVILL BE COAIPLIED WITH WHEfHER SPEC�FIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PPESUtdE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW AEGUL4TING CONSTRUCTION OR THE PERFOFMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERfORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 782yACW AND 296200 WAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />