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P�RMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />S�TE ADDRESS <br />S�S �� r on <br />LEGA lOTNO. BLOCK <br />DESC. <br />OWNER <br />1�`. �o /�n� k <br />TENANTNAME <br />' Su m( p� G f3d ✓G <br />CONTRACTOR <br />3v�- s9�z <br />PF10NE 4�as- '�,� <br />PROPOSED USE OF BUILDING <br />�2�s;d�n�,al <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />Rrmv�� �„� �¢cpla<< <br />Jnc�cr KJ�c�cn[C <br />PARCEL TAX I.D. R <br />TRACT <br />��S ����rl5an <br />CONTACT FOR PERI <br />SCrlip� StNlCU ' <br />PERMIT N <br />moyoi-r.�sZ <br />v�s - �sa- i��7 <br />Pt10Nt <br />y� S- 7S`1- Fr90 4 <br />`ADDRESS � ZIP CON7R. LICENSE N <br />S��s v�t *� A,,�. NJ �-o se�,o s5� ��3o N <br />/'✓1� K� I I't0 c.vA. t��7s -�Srs'! <br />Building Mechanical <br />PERMIT � Combination � Plumbing <br />TYPE Demolition Sign <br />Sprinkler <br />vV41G" �C1��Cf - /V�G1�� <br />NO. I TYPE OF FI%TURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <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�/BAR��/MQ P/GTCJ <br />OTHER i_n�.�.�yftL— � It�{r�c <br />NO. <br />Addidon <br />aceranon <br />New <br />Repair/Maint. <br />HEATSOURCE <br />�Electric <br />Gas <br />ome� <br />CITY OF EVERETT LOCAL SALES TA7C CODE IS 3705 <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <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 />F�REPLACE INSERT <br />GAS F�REPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS NPE OF WORK WILL BE COMPLIED WITH WHETFIER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES VOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />�i,�0 n .��%� �/��l�y <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />