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SITE ADDRESS <br />�27 G�� <br />LEGA LOT NO. <br />S�ERMIT APPLICA1SdN <br />CITY OF EVERETT PERMIT SERVICE:� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />a( A v� � <br />BLOCK <br />�o n �►r't, /%i� �l ✓ �✓Q� <br />TENANTNAME <br />CONTRACTOR [��s #J /KL <br />n-T(/ p <br />PHONE 36 a 652 9392 <br />PROPOSED USE OF BUILdNO <br />PERMIT <br />S��/1�/ `.� /y,tM� � TYPE <br />� rn.� r/ ! <br />CONTRACT PRICE OF WORK � <br />PARCEL TAX I.D. N <br />TRACT <br />ICONTACTNAME <br />ADORESS�/� f^ <br />PERMIT M <br />PHONE <br />LP CONTR.UCENSEN <br />,$e�a�rwom.0 kh `182t ��b rt�ocsi-� <br />Building I"1 Mechan�al I (� Addi�ion I HEAT SOURCE <br />Combination K Plumbfng WOnK j� Aiie:a�ron Eiectric <br />Demolition U Sfgn 7YpE B New � pe� <br />Sprinkler RepeidMeint. U Other <br />� CITY OF EVERETT LOCAL SALES TA% COOE IS 3105 <br />WORK DESCRIPTION /J � <br />c 1�1'I QGc- i'►-Y„�, <br />ak� �� qw w�-� <br />r:r.� <br />TYPE OF FlXTUpE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WA�H BASIN) <br />SHOWER <br />KITCHEN SIIJK 8 DISPOSAL <br />OISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFIOW PREVENTER <br />SINK (SERVICEIBAR/MOPlETC.) <br />OTHER <br />��l a� -e�.i. sr„�t- r/�1: <br />/c..�.-L'�c r�p�s�e� .c2�.��. <br />NO. � TYPE OF Fl%TURE OR REM <br />_ A/C - A/HANDLING UNITS <br />_ FORCED AIR SYSTEMS <br />_ HEAT PUMP <br />_ UNIT HEATERS <br />_ CIOTHES DRYER <br />_ RANGE HO00 <br />�_ WATER HEATER <br />_ METAL FIREPLACE/STOVE <br />_ FIREPLACE INSERT <br />_ OAS FIREPLACE <br />_ GAS RANGE <br />_ GAS PIPING <br />_ EXHAUST FAN <br />_ OTHER��� <br />�, � �s T1trr�i <br />I HEREBY CERI7IFY 7NAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br />PROVISIONS OF L4W5 AND OFIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br />�OT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOUITE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OH LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PEFFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 qCW AKD,/96.200 WAC. <br />