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� <br />� �ERMIT APPLICA�� ION <br />CITY OF EVERFTT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS � / <br />SZD QUSC WC � <br />LEGA LOT NO. BLOCK <br />DESC. � S� � �� <br />oo��e�1 U <br />TENANT NAME <br />CONTRACTOR �y'�a��� ypmfS <br />PF10NE yZs-zsy-y�o <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />PARCEL TAX I.D. S <br />TRACT G�f ha�i � <br />fl�F �icr�.F �«o, <br />ADDRESS <br />� G� <br />CONTA TNAME <br />D��,� ,e.6,� r1 <br />AODRESS <br />PERMIT F <br />4 oa�s -oa � <br />Z3, Peck� <br />�t t✓A 98t�� ytc=Zs�-5o00 <br />PHJNE <br />425- SOS-S�Iyv <br />21P CONTR. LICENSE M <br />�Gvl Co��� f}✓t fye,rc lj U�i 46201 ,�Ud/N�7CO2S�.CB <br />Building Mechanical Addition HEAT SOURCE <br />PERMIT � Combination � Plumbing WORK � Alleretion li Electrtc <br />TYPE Demolilion Sign 7YPE New �i� ����1 pes <br />Sprinkler Repair/Meint. IJ Olher <br />CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION ' lew �jw4 � <br />��/ <br />NO. � TYPE OF F�XTURE OR ITEM <br />_ WATER CLOSET <br />_ BATHTUB <br />_ LAVATORY (WASH BASIN) <br />SHOWER, <br />KITCHEN SINK.B DISPOSAL <br />_ DISHWASHER <br />LAUNDRY TRAY <br />_ CLOTHES WASHER <br />_ URINAL <br />DRINK�NG FOUNTAIN <br />_ FLOOR DRAIN <br />_ BACKFLOW PREVENTER <br />_ SINK (SERVICE/BARlMOP/ETC.) <br />OTHER_ <br />N//� <br />NO. � TYPE OF FlICTURE OR ITEM <br />_ A/(; — A/MANULING UNITS <br />_ FORCED AIR SYSTEMS <br />_ HEAT PUMP <br />_ UNIT HEATERS <br />_ CLOTHES DRYER <br />_ RANGEHO00 <br />_ WATEfl HEATER <br />_ METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />_ GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />_ EXHAUSTFAN <br />_ OTHER <br />N/� <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIJNS 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 OTHER <br />STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERIY TO PERFORM THE WOflK FOR `NHICH APPLICATION IS MADE AYD I COMPLY WITH THC STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />�/ � w / �J"V i����'�7 <br />� <br />