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P�I�MIT 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 />LOT N0. <br />r�,Z.y s rs c�'sep <br />TENANTNAME <br />� �1 Q'� 3 PARCEL TAX I.D. i � <br />O <br />�K� ""`�r _ Q LA, Pl�'/V- U <br />o, � �Y 9 �,� !/% 9 <br />CONTRACTOR <br />-.ItS,o� C/'� �� <br />PHONE �� �^ _2 �/ t� ,r-q� <br />w l _� ( <br />PROPOSED USE OF BUILDINO <br />' i � i <br />CONTAACT PRICE OF WORK <br />CONTACTNAME <br />G�tv S.S�_s <br />G ADDR �� ��� �`� �/� CONTR. UCENSE I <br />� " �'�+ H'°'� �{9g0 E. <br />9�3 <br />�Ildlnp DMechenk.al <br />PERMIT mbination �] Plumbing <br />TYPE rtroIltlOn U Slyn <br />Sprinkler <br />Addttbn <br />Allerelbn <br />N�w <br />'.� Qp�iqMaint <br />�� <br />CRY OF EVERETT LOCAL lALEt TAIt COD[ IS �106 <br />WOHKDESCRIP710N . . � � � �� '/ � ii/� <br />%Q�,,. .,Da.�x.. d-�- ��� r..r. <br />N0. I TYPE OF fl7(TURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 3 DISPOSAI <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICElBAR/MOP/ETC.) <br />OTHER <br />NO. I TYPE OF Fl%TURE�OR RFIA • <br />A/C - NHANDLINQ UNITS <br />FORCED AIR SYSTEMS ; <br />HEAT PUMP - <br />UNIT HEATERS <br />CLOTHES DFYER <br />RANOE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />aAS FIREPLACE <br />�AS RAN�E <br />CiAS PIPINO <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNINO THIS TYPE OF WORK WILL BE COMPLIEO NRTIi WHETHER SPECIFlED HERQN OR <br />NOT. THE 6RANTIN6 OF A PERMIT DOES NOT PRESUME TO OIVE AUTHORITY TO VIOUTE Oq CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL lAW REGULATINO CONSTRUCTION OF; THE PERFORMANCE OF CONSTAUCTION. 7}U►T I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEFjj'`F70 PERFORM THE WORK FOR WHICH APPLICATION IS MA�E AND I COMPLY WITH THE STATE <br />CONTRACTOFIS LAW 18/f� pdW AND 298.200 WAC. <br />