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� <br />PERMIT APPLICATION <br />CITY OF EVcRETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS �a PARCEL TAX I.D. A <br />/ �� ?{ /T <br />Y9iv ✓5r.� � <br />LEGA LOTNO. BLOCK TRACT <br />DESC. <br />���R ADDRESS <br />FR�c �v�✓�O,EEN y9�o Us7�9 i� <br />TENIINT NAME <br />,SAME <br />CONTRACTOR <br />y1n�. <br />PHONE <br />PROPOSED USE OF BUILDING <br />� Sf= �2 <br />CONTRACT PRICE OF WORK <br />ICONTACT FOR PERMIT <br />ADDRESS <br />Building Mecnaniwi <br />PERMR R Combination Plumbing <br />nPe D Demolition Sign <br />U Sprinkler <br />�rp2oS <br />y'2s' ,2str �� v3 <br />PHONE <br />�Jp CONTR.LICENSEt <br />AdAilion <br />Afteration <br />New <br />Repair/MaiM. <br />HCM JVYRMC <br />Q Electric <br />Pf c�a <br />U Other <br />CITY OF EVERE7T LOGAL SILLea � nn �u�c ��., ��� <br />WORK DESCRIPTION v � � <br />Rei,�.+�.��,�r- ,�vo �eE<o�,aro�.v c� I✓�rr2 b��qr�e <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCFEN SINI( 8 DISPOSAL <br />DISHWASHER <br />IAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. I 7Y?E OF FIXTURE OR ITEM <br />AIC — A/HANDLING :JNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DHYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACeISTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION AND KNOW THE SAME TO BE l RUE ANu WHnc�, i. n�� <br />PROVISIONS OF LAWS AND ORIDINACES GOVcRNING THIS NPE OF WORK W ILL BE :OMPLIED WITH WHETHER SPFCIFIED 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 />STATc OR LOCAL lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTAUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITM TME STAiE <br />CONTRACTORS LAW 1827 FCW AND 296200 WAC. <br />i- �.�. 9_ r.a _ o� <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />