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PtRMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-585'7 <br />SITE ADDRESS <br />�'S zr �����e� A�� w. <br />LEGA LOT NO. BLOCK <br />�A,ncl� 7e [lc �,o � <br />TENANTNAME <br />�..�---J <br />CONTRACTOR � <br />� � �. J ��.k, �� 5 <br />PHONE <br />2�c�-zy�--���o <br />PROPOSED USE OF QUILDING <br />CONTRACT PRICE OF WORK <br />PARCEL TAl( I.D. If <br />� uc��2tt' <br />TRACT <br />pDDRESS {}- <br />'Z I I�cvG�CRr F�V C. W. CuCJrC 4 <br />CONTACT FOR PERMIT <br />a <br />cs 3 <br />03(�i25-3u�-YI <br />PHONE <br />ADDRESS ZIP CONTR. LICENSE N <br />�yuu ��ce�.. AH�.e .Auc,V. �254- �L�nh,�couS�a7 <br />Se�iiile,w a `i8109 <br />Building ❑ Mechanical <br />PERMIT �Combination U Plumbing <br />TYPE Demolition U Sign <br />Sprinkler <br />TYPE <br />AOdition <br />Allera6on <br />New <br />RepairlMaint. <br />HEATSOURCE <br />�ElecUie <br />Gas <br />Other <br />CITY OF EVERETf LOCAL Snles 7n7c cooe �s siw <br />WORK DESCRIPTION �� f 1�k 1e� �� S��y �,�.� n��� �• U vL <br />NO. I TYPE OP FI%TURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING hOUNTAIN <br />FLOOR DRAIN <br />� BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO.. I TYPE OF FIXTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />i HEREBV CERITIFV THAT I HAVE ftEAD AND EXAMINED ?HIS APPLICATION AND KNOW THE SAME TU BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL 8E COMPLI'cD W�TH :^.�HETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLA?c UR CANCEL TNe f 4nVISION OF ANY OTHER <br />STATE OR l,0 LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF C(��JSTRUCTION. TH,1T I AM AU7HORIZED BY THE <br />OWNEg-OF THIS ROPERTV TO PERPORM THE WORK FOR WHICH APPLICATION I; MADE AND I COMPLY WITH THE STATE <br />COI�Fi2ACTORS W 18 CW AND 296.200 WAC. <br />i . �..; _ ��-1— � 3 <br />DEBIT 8 CREDIT CARDS ARE NOl' ACCEPTED <br />