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� <br />SITE ADDRESS <br />�or No. <br />DESC. <br />PtRMIT APPLICATIVN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />BLOCK <br />/ PARCEL TAX I.D. N <br />X <br />TRACT <br />�v�o [�,z,�+�r�..,�. lsig L.l Mk ��-� Td..�n� 98zo�. �s�2�. ►�+�4- <br />TENANTNAME I CONTACTNAME PHONE <br />� %S - :�8o iJ t'L_ <br />CONTRACTOR DOR SS AP CONTR. LICENSE N <br />i�ol.a►� GOI�S"� �Q.6o1� Z� q / <br />PI10NE �y�(��.T� 1��! <br />�'t �ri-3�53-7crr4 13aLi�� 1oIMF <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />� WATER CLOSET <br />BATHTUB <br />= LAVATORY (WASH BASIN) <br />SHOWER <br />�T KITCHEN SINK & DISPOSAL <br />_ DISHWASHER <br />_ LAUNDRYTRAY <br />_ CLOTHES WASHER <br />_ URINAL <br />_ DRINKING FOUNTAIN <br />_ FLOOR DRAIN <br />BACKFLOW PREVENTER <br />_ SINK (SERVICE/BAR/MOP/ETC.) <br />_ OTHER <br />Building <br />PERMIT Combination � <br />7YPE Demolition <br />Sprinkler <br />Mechanical Adtlition HEATSOURCE <br />Plumbing WORK Alterafion RElectric <br />Sign 7YPE New }�LGas <br />Rapair/Ma(nL LJ Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />N0. � TYPE OF FIXTURE OR ITEM <br />A/C —.0/IIANDLING UNITS <br />FORCLD 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 />EXHAUSTFAN <br />OTHER <br />I HEREBY CERIT�FY THAT I HAVE RFAD 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 OTHEF <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PFOPERTY TO PERFORM THE WOFK FOR WHICH APPLICATION IS M� 7E AND I COMPLY WITH THE STATE <br />CONTA�ORS LAV! 18.27 RCWAND 296200 WAC. <br />