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I <br />�r�ERMIT APPLICAI �ON <br />CITY OF EVERETT PERMIT SERVICES �'U-3U2—� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />��� �:.�s/ /2r <br />SITE ADDRESS <br />LOT NO. I BLOCK <br />� <br />PARCEL TAX I.D. # <br />s�3G - oo� �- oo�� -� <br />� -nlr- l•��� <br /># <br />�2- C��; ; <br />TENANT NAME I CONTACT FOR PERMIT PNONE <br />/� / <br />I �CG�f G . L %t✓%J? 'S .?O . • �UO � ��i'f,�' <br />CONTRACTOR � ADDRcSS ZIP CONTR. LICENSE p <br />���-! �rn /b f•r(�/ ��:�T�o /1/. ��l i'l� �y'Co/Jf� J!� 97.e./rJ <br />PHONE <br />�7n/ _ -l., .. . i�t�� G <br />PROPOSED USE OF BUILDING <br />�� <br />CONTRACT PRICE OF WORK � <br />WORK DESCRIPTION <br />,/I,��IV <br />NO. I TYPE OF FIXTURE OR ITEM <br />�{ WATER CLOSFT (TOILET) <br />/ BATHTUB <br />1 LAVATORY (WASH BASIN) <br />,L SH�WER <br />/ KIT.^,HEN SINK �. DISPOSAL <br />/ DISr'WASHER <br />/ LAUNDRYTRAY <br />/ CLOTHES WASHER <br />— URINAL <br />� DRINKING FOUNTAI�� <br />L FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP�ETC.) <br />OTHER <br />Building D Mei:hanical <br />PERMIT Combination U Plunbing <br />TVPE Demolition U Sigi <br />Sprinkler <br />Addition HEATSOURCE <br />WORK R Alteration � Eiectric <br />TYPE D New Gas <br />U RepainMainl Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />NO. I TYPE OF FIXTURE OR ITEM <br />— WC—A/HANDLING UNITS <br />Z FCRCED AIR SYSTEMS <br />— HEAT FUMP <br />UNIT HEATERS <br />_L CLOTHES DRYER <br />i RANGEHOOD <br />_[__ WATER HEATER <br />— METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />� GAS FIREPIACE <br />— GAS R,4NGE <br />/ GAS PIPING <br />� EXHAUST FAN <br />OTHER <br />� HEREBY CERITIFI' THAT I HAVE READ AND E,`WAiINED THIS APPLICATION AND KNOW THE SAME TO 0E TRUE AND CORRECT. ALL <br />� PROVISIONS OF LAWS ANU ORIUINACcS GOVERNING THIS TYPE OF N'ORK LVILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />; NOT. THE GRANTING OF A PERMIT 90E5 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 I AM AUTHORI2E0 BY THE <br />i6h'fJER OF THIS PROPERTV TO PFRFORM THE WORK FOR WHICH APPLICATION IS MADE AN� I COMPLY WITH THE STATE <br />,:ONTRACTORS ��2�C�' -AN4396.,'�9'CV� <br />� Signature of OwnenContractonAut onzed Agent Date ,, <br />' DE81T 8 CREDIT CARDS ARE NOT ACCEPTED � <br />