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�ERMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />7601 S NLJFCL <br />rno309-D�q <br />LEGAL LOT NO. <br />BLOCK <br />DESC. <br />OWNER ADDRESS ZIP PHONE <br />zTb l S ay.� KLA_ iF <br />TENANTNAME <br />CONTACT FOR PERMIT PHONE <br />CONTRACTOR ` ADDRESS ZIP CONTR. LICENSE # <br />1 <br />PHONE ,L-tlS_ ^ ^ o � (� 2 ' ten^ CL J -,%otktea'otinn <br />PROPOSED USE OF BUILDING <br />BuildinPERMIT CoTYPE mbination bing eclancal <br />n Plumbing <br />HEATSOURCE <br />_ <br />on 9n <br />WORE <br />�.3Jj <br />SprinklerLher <br />pL <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />.�V�SiA�\ Y�C'� Fu2vXl�G6` <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />A/C-A/HANDLING UNITS <br />_ <br />BATHTUB <br />j <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHOWER <br />UNIT HEATERS <br />_ <br />KITCHEN SINK & DISPOSAL <br />CLOTHES DRYER <br />_ <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />_ <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />BACKFLOWPREVENTER <br />GAS PIPING <br />_ <br />SINK (SERVICE/BAR/MOP/ETC.) <br />EXHAUST FAN <br />_ <br />OTHER <br />OTHER <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS 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 REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />C'NER <br />. TRACTORS LAW 18.27 RCVJ AND .96.200 WAC, <br />nature of Ownek Contractor/AuthorIzOld Agent Date <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />