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FC:RMIT APPLICAM N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D.1 PERMIT N <br />LEGAJ LOT NO. BLOCK TRACT <br />/UGC vcxr <br />TENANT NAME <br />CONTRACTOR <br />PHONE <br />CONTACT NAME <br />ADDRESS <br />M <br />1.203 1-/zs 19s�q <br />PHONE <br />ZIP CONTR. LICENSE 0 <br />PROPOSEDUSE ILDING <br />B Id <br />Mach 'ai^gel <br />TSOURCE <br />H�LJ <br />PERMIT <br />CuorribB <br />Plum <br />WORK <br />AAddition <br />teration <br />11 <br />Electric <br />TYPE <br />Demolition <br />Demolillon <br />Sign <br />V Sign <br />LJ <br />TYPE <br />F-( Nev <br />Gas <br />LKJ <br />LJ Riepatr -int. <br />Other <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />PLUMBING <br />NO. TYPE OF FIXTURE OR REM <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />� ,� <br />( <br />( X_ <br />A/C — AMANDLINGUNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER I- <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE - I <br />GAS RANGE. <br />GAS PIPING <br />EXHAUST FAN <br />OTHER a .4 ig <br />_ <br />_ <br />=SHOWER <br />_ <br />_ <br />_ <br />= <br />_ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTR/9/ RS LAW 18.27R/CC NO 296.200 WAC. <br />