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PE�MIT 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 PARCEL TAX I.D. # PERMIT� <br /> �IZD �Foc,��//�r # / M�-IUS- v�`� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DEcSC. <br /> OWNER ADDRESS ZIP PHONE I <br /> �� y�� s�A�.rv,�l �s�z� 3r�c�,.. sc �a,ii �,�r� c�r� 9�z�i2 <br /> TENANTNAME CONTACTFORPERMIT PHGNE <br /> � r�'�yy,� �I'w�1�'sa� (:�e�� 5�r-7- �.us <br /> CONTRACTOR ADDRESS ZIP CONTF.LICENSE# I <br /> I <br /> PHONE <br /> PROPOSED USE OF BUILDING � Building n Mechanical Q Atldilion HEAT SOURCE <br /> PERMIT Combination H Plumbing WORK �__) Alteration � Electric <br /> TYPE Demolilion LJ Siqn TYPE D New Gas <br /> �;�rinkler U RepairfMainL Other <br /> CONTRACT PRICE OF WORK CITY Of EVERET('LOCAL SALES TAX COOE IS 3105 <br /> � WORK DESCRIPTION <br /> �1 �SN�L7 GdK' CdJE GD�^-�PLl�1-�VC� <br /> PLUMBING MECHANICAL <br /> NJ. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) NC—NHANDLWG UNITS <br /> BATHTUB FORCE�A�R SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOINER UNIT HEATERS <br /> KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY � WATER HEATER <br /> CLOTHES WASHER MET'r,L FIREPLACE/STOVE <br /> URINAL FIRFPLACE INSERT I <br /> DRINKING FOU�TAIN _ GAS F!REPIACE I <br /> FLOOR DRAIN GAS RANGE i <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICErBAR/h10P/ETC.) EXHAUST FAN <br /> i OTHER OTHER <br /> , — <br /> I HEREBY CERITIFY THAT I HAVE READ AND E?(AM1iINED THIS APPLICATION AND KN01N THe SAME TO BE TRUE AND CORRECT. AlL I <br /> ' PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF 1VORK WILL BE COAIPLIED WITH 1NHETHER SPECIFIED tiEREIN OR . <br /> NOL THE GRANTING OF A PERMIT DOES NOT PRESUAtE TO GIVE aUTHOR1Tl'TO VIOWTE OR CANCEL THE PROVISION O'r ANY OTHER �� <br /> STATE OR LOCAL LAW REGUlA71NG CONSTRUCTION OR THE PERFORAIANCE OF CONS?RUCTION. THAT I AA9 AUTHORIZED BY THE I <br /> '� OWNER OF THIS PROPERTY TO PERFORM THE WORK FCR WHICH APPLICATION IS M1tADE AND I COMPLY WITH THE STATE , <br /> ICONTRACTORS LAW 1&27 RCW AND 296200 WAC. ' <br /> (� �� S,/j/�' 1 I <br /> Sfy3iatu�wnerlContractorlAuthonzed Agent Da�e i <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED � <br />