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P�RMIT 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 a <br /> 1t ► �1 ls� �v� s � F.�,r4� MaKos-c�r <br /> LEGA LOTNO. BLOCK TRACT <br /> UESC. <br /> OWNER e ADDRESS ZIP PHONE <br /> �i� �nc�)�� U��-, � � I I 1 � s� ALe S � ��Z� 42S- 3y�• 622� <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> PHONE / /���� <br /> V <br /> PROPOSED USE OF BUILDING Buiiding � Mechanical I Addition HEAT SOURCE <br /> PERMIT R�.-( Combination Plumbing WORK Altera6on Q Electric <br /> TYPE �] �emolition Sigr. TYPE New Lj Gas <br /> U Sprinkler Repair/Mainl. L.� Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TA7C CODE IS 3105 <br /> WORK DESCRIPTION <br /> �����'�PIG `'�-' <br /> � <br /> PLUMBING MECHANICAL <br /> N0. TYf'OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HAND�ING UNITS <br /> BATHTUB ^ FORCED AIR SYSTEMS <br /> U�VATORY(WF�H BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN S�NK 8 DISPOSA� CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY _ WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACEISTOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN � GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER Z� GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER _ OTHER <br /> I I HEREBY CERITIFY THAT I HAVE READ AND EW+MINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> IPROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH bVHETHER SPEGFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUh1E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERPORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE I <br /> OWNER OF THIS PROPERTY TO PERFORAI THE WORK FOR WHICH APPLICATION IS MADE AND I COAIPLY WITH THE STATE . <br /> C�TR�ACTORS 18.27 RCW AN�296.200 WAC. ', <br /> `-� �i�J ��r�.�t� S- 1 I -a`� <br /> Signature ot OwnedContracrodAuthonzed Agent Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED I <br />