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PERMIT APPLICATION <br />APPLICATIONCITY <br />CITY OF EVPPEn PERMIT <br />OF EVERETT PERMIT SERVICES3200 <br />CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 —FAX 425-257-8857 <br />SITE ADDRESSPARCEL TAX I.D. N PERMIT � <br />�[�j�L,9,�%�'38a� o00 oos-o��LEGA <br />LOT NO. BLOCK TRACT <br />DESC.OWNERADDRESSLPPHONE��R�c� <br />l � <br />!�A/o���j�/ects,rc��%✓�9�us <br />TENANTNAMEICONTACTNAMEPHONE <br />Sgwt�CONTRACTOR���eNd()LADDRESS(/�vn�hJ�f�aZIPCONTR. <br />11 <br />.r...S-3T..*G��wil w... ilY.'1IM.✓Me n m... r.�.n. <br />LICENSE N�PHONE <br />9��°�,-]�QC►2199�o�rPROPOSED <br />9n�FAIteration <br />RI9�''i.'�".ob <br />—mm..�... n. � <br />USE uF BUILDINGingMechanicalHEA7S�URCEPERMIT Plumbing WORK <br />` <br />rCombination <br />'r•,'E TYPEewprinkl/er <br />�i..e^,.�.....•H.: <br />emolitionSiyn <br />epeirlMaint. Other <br />CONTRACT PRICE OF WORK Iq r /_AAx 0 CITY OF EVERETT LOCAL SALES TAX CODE IS 3I05 <br />1 lC� <br />WORK DESCRIPTION . <br />I <br />1 <br />' PLUMBING � MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />NC — NHANDLING UNITS <br />_ <br />6ATI4TUB <br />FORCED AIR SYSTEMS <br />LAVATORY )INASI-i BASIN) <br />HEAT PUMP <br />_3 <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISPOSAL <br />CLOTHES DRYER <br />_ <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />WATEF+HEATER <br />MEIALFIREPLACE/STAVE <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />_. <br />GAS FIREPLACE <br />FLOOR DRAIN <br />GAS RANGE <br />_ <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />� <br />GAS PIPING <br />EXHAUST FAN <br />OTHER_ <br />OTHER - -- <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 OHIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED \'d! FH 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 IRE <br />OWNER OF THIS PROPERLY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />y......>..'.�."°PERMIT <br />CONTRACTORS LA .27 R 296.2 A WAC. <br />Signature oer/C Ir< or/Aul rizod Agent ale I/ <br />