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PERMIT 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 />PARCEL TAX I.D. # <br />oo <br />PERMIT # <br />DO 'YJv7 - 73 2 <br />0/ S <br />D OLIDG-oab <br />LEGAL LOT NO. <br />BLOCK <br />TRACT r%.Cir7 <br />DESO. <br />-,7J 2 <br />,E ram- c 7`� ��'✓ // <br />P�4f <br />OWNER <br />ADDRESS <br />ZIP <br />PHONE Z1,230 <br />TENANTNAME <br />CONTACT FOR PERMIT <br />PHONE <br />CONTRACTOR i.y � <br />ADDRESS <br />ZIP <br />CONTR. LICENSE # <br />PHONE <br />PROPOSED USE OF BUILDING Building Mechanical Addition HEAT SOURCE <br />PERMIT C mbination IR-( Plumbing WORK Alteration R Electric <br />TYPE emolition LJ Sign TYPE New u Gas <br />Sprinkler Repair/Maint. LJ Other <br />CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />WORK DESCRIPTION <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & 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 />A/C — 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 />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <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 I 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 />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />