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PERMIT APPLICATION `1 <br />CITY OF EVERETT PERMIT SERVICES r r <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D. # P MIT # <br />362o tMCPou At-t' Uc 00SI 000c(ODOO1 ` <br />LEGP.L LOT NO. BLOCK TRACT <br />DESC. <br />I\A�woNY <br />tA%VFSTVA%FNTS <br />6j% %%-1 j�o/GTW O <br />OR �72a4� <br />TENANT NAME <br />CONTACT FOR PERMIT <br />PHONE <br />PLA-TC <br />C <br />SKAtw'--5 P�1 <br />0 o67-2Z0 <br />CONTRACTOR <br />ADDRESS 1� p S LrT}I ZIP <br />Cu.. (R. LICENSE # <br />ounuc is..r <br />�n Z tIn7 <br />lCP- 1\ 1c I JA, 9.612, <br />PROPOSED USE GF BUILDI14G <br />PERMIT <br />Building <br />Combination <br />Mechanical <br />Plumbing <br />`Sign <br />Addition <br />WORK R Alteratlon <br />I <br />I HEAT SOURCE <br />Gas Electric <br />TYPE <br />Demolition <br />TYPE <br />R�—„a.t 1,— <br />Sprinkler <br />RepalrRUalnL <br />Other <br />CITY OF <br />EVERETT LOCAL SALES TAX CODE IS 3105 <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION - <br />l tll S'C,P,; U. 0"� gt� G k" qq-XT <br />(n,W,-UI- 516v-• <br />PLUMBING <br />NO. 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 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBAR/MOP/ETC.) <br />OTHER <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />AIC—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 />_ <br />_ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THt JAW.t i U ct i nv- ,.,.v .••��� • • • •-- <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE OF A STATE OR LOCAL GRANTING <br />LAW REGULATING CONSTRUCTION OR THE PERFORMANCE PROVISIONRITY TO VIOLATE OR CANCEL THE <br />ANCE OF CONSTRUCTION. CT ON. THAT I AM AUTHORIZED BY HE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 10.27 RCW AND 296,200 WAC. <br />15 <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />