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tRMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />SITE ADDRESS <br />$'3/ <br />LEGAL LOT N . <br />DESC. <br />OWNER n � <br />r.�ri <br />� <br />TENAN7NAME <br />CONTRACTOR (� <br />lbJa�o� <br />PHONE ,�GaS-,�, <br />PROPOSED USE OF BUILDING <br />�• <br />PERMIT <br />TYPF <br />CONTRACT PRICE OF WOnK 3L�� <br />WORKDESCRIPTION ��� -�� (�U,) <br />/ <br />MO. I TYPE OF Fl%TURE OR ITEM <br />WATER CIOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWEFi <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FL0017 DRAIN <br />BACKFLOW PREVENiER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />PARCEL TAX I.D. M <br />TRACT <br />ADDRESS,^' � ,� <br />83/ ��, i <br />T <br />CONTACT NAME <br />ADDRESS <br />PERMIT N <br />PMONE <br />��s-,�,�q—a3�s� <br />PHONE <br />CONTR. UCENSE N <br />�G/D �����-,� ��, �p I OE+°F,vr�✓Noi�kk <br />�i,���tC /,�ill. : �.�o� <br />Building n Mechanica! I Addition HEAT SOURCE <br />Combination [} plumbing WORK Fiieretion Eiectnc <br />Demolition � Sign TYPE New �Ges <br />Sprinkler Rapair/Meint. Other <br />CITY OF EVERETT LOCAL SALES TA7( CODE IS 3105 <br />( ( �'n✓ <br />N0. � TYPE OF FlXTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEAIS <br />HEATPUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPL4CEISTOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS A�D ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br />NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITY TO VIOL4TE OR CANCEL TFIE PROVISION OF ANV OTHER <br />STATE OR LOCAL L4W REGUTATING CONSTRUG'ION OR ThiE PEflFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR�ZED 8Y THE <br />OWNER OF THIS PROPERN TO PERFORM THE WORK FOR WNICH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTOR¢ L4W )8.27 RCW AND 296200 WAC. . <br />