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PERMIT APPLICATIO`N <br />CITY OF EVERETT PERMIT SERVICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />.�ri i r u <br />LEGAL LOT N0. BLOCK <br />OESC. <br />OWNER <br />c.cS � <br />TENANT N/VdE <br />CONTRACTOR <br />PHON� � <br />ND ��•�1iS �C <br />PROPUSED USE OF BUILDING I <br />S,�/' PERMIT <br />�' / C� TYPE <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />TRACT <br />ADDRESS <br />ICONTACTFORPERMIT <br />ADDRESS <br />G,�, <br />� <br />�Building � echanic <br />Combination Plumbing <br />Uemoiition Sign <br />Sprinkler <br />�r�od � <br />NO. � 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 (SERVICE/BAR/MG�•/ETC.) <br />OTHER <br />PERMIT # <br />Bo yOS-0; <br />PHONE <br />S� / � �� <br />PHONE <br />ZIP CONTR. LICENSE S <br />, <br />.v , r �p� -i,rr,� <br />Addition HEATSOURCE <br />2N Alteration � Electric <br />E New Gas <br />RepairlMaint. Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9705 <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/G — AIFiANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />_� OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAM1IINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF I.AWS AND OkI�INACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT COES 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 />CONTRACTOPS LAW 18.27 FjCW AND 29620� WAC. <br />DEBIT � CREDIT CARDS ARE NOT ACCEPTED <br />