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1AN-24-02 THU 10�52 AM E�cRETT PERMIT SERVICES FAX N0, 47_5 257 8857 P, 02 <br />. , �- �� <br />PERMIT APPLICATION <br />��%„.-T�, CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERCTT, WA 98201, 425-257-BR10 <br />sn�e aooRess <br />51025 �v�U� /���e- <br />o�sc. <br />OWNER <br />TENANT NAMC <br />PHONE <br />PROPOSED USE OF BUILDING <br />CDNTRAC7 PpICE OF WOpK <br />PARCEL TAX I.D. N <br />CONTAC7NAME <br />PERMIT x <br />�o co�aa-o�� <br />iv L <br />PHONE <br />. L5 - - <br />� PHONE <br />� '�J%-c�S�f'. � 2 <br />� CONiR. LICENSE A <br />p� Building �j Mechanicnl �I;.t� Addhion HEAT SOURCE <br />PEpM1T D Combination pp Plumbing WORK .Q4 Alleration Q Eiaciric <br />IYPE 1� Demolilion p Sign 7YPE D raow L�d Ges <br />D Spdnklsr D RepaidMelnt. U Othcr <br />�,5��,-�� �' CITYOFkIIERETTLOCALSA�ESTA%COD815�105 <br />WORK DESCRIPTION <br />A�kli�jcril/'��ur10D�L <br />N0, � TYPE Of� FI7(TURE OR ITEM <br />� WATER CLOSET <br />I _ BATHTUB <br />�LAVATORY (WASH BASIN) <br />SHOWER <br />__ KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />� LAUNDRY TRAY <br />._, . CLOTHES WASHER <br />,_._ 11RINAL <br />DRINKING FOUNTAIN <br />� FLOOR DRAIN <br />6ACKFLUW PREVEN7ER <br />= SINK (SFRVICE/BAR/MOP/ETC.) <br />_ OTHEfi _ <br />NO, � TVpE OF FIXTURE OR ITEM <br />A!C — AMANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNI7 HEATERS <br />CLOTHES DRYER <br />RAN�EHOOD <br />WATER HEATER <br />METAL FIREPLACFJSTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />OAS RANOE <br />OAS PIPINLi <br />EXHAUS7FAN <br />OTHER <br />I H:FiEBY CEi11TiFV TIiAT I HAVE FlCAD ANU EXAMINED THIS APPLICATIOA! AND KNOW THE SAME TO BE TRUE A�D CORRECT. ALL <br />PROVISIONS Of- LAWS AND ORIDINACES GOV�RNING THIS T'PE OF WORK WILL BE COAIPLIED WRH WFiEI"HEf15PECIFIEO ! IEREIN OR <br />NUT. TfIE GRANTING OP A PGRMIT DOE5 NOT PRCSUME 70 GIVE AU7HOflIlY TO VIOLATE OR CANCEL THE PROVISION OF ANY O?HER <br />STATE OR LOCAL LAW RFGUTATING CONSTRUCf10N OR THE PEFFORMANCE OF CONSTRUC7ICN. THAT I AM AUTHORIZED 8Y TNE <br />OWNER OF Tl ll.i PROPERTY TO PERFORM 7HE WORK FOR WHICH APPUCATION IS MADE AND I l:OMPLV W17H TH[ STATE <br />Cp�TRACTORS LAtN 1027 RCW AND 296.200 WAC. <br />'/a) <br />