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PtRIlIIIT 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.# PnE_RMIT# <br /> �� �'�� � U � C. � � W`t L'Z"rl / <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> �ER A�ORESS ZIP PHONEZSC� y� <br /> n : irt lN 01�1 z�v � U (L�� �I �'<</-[� ( �Zv � <br /> . ENANTN ME CONTACTFORPERMIT PHONE <br /> CONTRACTOR AUDRESS ZIP CONTR,LICENSE p <br /> PHONE <br /> PROPOSED USE OF BUILDING pERM1T � Spr nk��ation U Plumbinga� WORK B Repa'��rlMainL HEAT SE eRVic <br /> TYPE DemOliliOn U Sign TYPE New Gas <br /> Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION r.� „ lG t—� �O O �— <br /> f�� <br /> 3 -+K� <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SItJK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE�NSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EYHAUST FAN <br /> OTHER OTHER <br /> I I HERFBY CERITIFY THAT I HAVE READ AND EXAAIINED THIS APPLICATION AND KNOW THE SAME TO 9E TRUE AIJD CORRECT. ALL <br /> I PROVISIONS OF LAWS AND ORIDINACES GO�'ERNING THIS TYPE OF WORK WILI BE COh1PUED WITH WHETHER SPECIFIED HEREIN OR <br /> ' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOfATE OR CANCEL THE PROVISION OF ANY OTHER <br /> � STATE OR LOCAL LAN'REGUTATING CONSIRUCTiJN OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIlED BY THE <br /> I OWNER OF'HIS PROPEZN TO PERFORM THE WORK FOR WHICH APPUCATION IS MADE AND I COMFLY WITH THE STATE <br /> � CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> i' ) p <br /> ♦ /�.�-c�1�1 C� � /� .�/ ��.� <br /> I Signature of 0 edContractor/Aut nz Agent Date <br /> � �DEBI'� & CREDIT CARDS ARE NOT ACCEPTED <br />