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PERMIT 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 <br />�7� SPoKav� �' <br />LEGA LOTNO. BLCGK <br />� E�' <br />PARCEL TAX I.D. X <br />�80 5 ogpp 300 7ov <br />TRACT <br />ADDRESS <br />QYI� �f' �1/�^f �%�: <br />/D � � 5�-03 <br />�� �io_��� <br />PERMIT A <br />n1 "�� � c oU.�- <br />1�Q� <br />7ENANT AME + CONTACTFORPERMIT PHONE <br />I Candi� C-xt l lqg l� 2oro z�2 �� <br />CONTRAC70R � ADDRESS 21P CONTR. LICENSE r <br />w�}S+� � nq ��� �/ICFr SP��-�a_ l.U�}SK I CS�lO(3 <br />�o"� z�z. �1-� 2$on�s-ncI yrc.E Ave cJ q� I q� <br />PROPOSEDUSEOFBUILDING I � Building � Mechanical �Additlon I HEA�WRCE <br />?=RMIT Com6inafwn Plumbi�g WORK Alteratlm Electric <br />��iaE Damolition Sig� TYPE New Gas <br />� Sprinkler RepairlMalnt Other <br />CONTRACT PRICE OF WORK 2�( 9� — CITY OF EVERETT LOCAL SALES TA7f COOE IS 7105 <br />WORK DESCRIPTION � <br />�q n s-I� I l�l e_c,-f-�-� ��u��z'1a Ce, <br />�ahf �Mg�'��aSZ� isw.�rr <br />NO. � TYPE OF FIl(TURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASINj <br />� SHOWER <br />KITCHEN SINK & DIS�OS4L <br />DISHWASNER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DR111N <br />BACKFLOW PREVE��TER <br />SINK (SERVICE/�AR/MOP/ETC.) <br />OTHER <br />NO., <br />TVPE OF RI(TURE OR ITEN <br />AIC - AIHANDLING UNITS <br />FORCED AIR SVSTEMS <br />HEATPUMP <br />UNIT HEATERS <br />CLOTHES ORYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIRcPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I MEREBY CERITIFV THAT I HAVE HE40 Ahp E.WMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COi3RECT. ALL <br />PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED WITM WMETHER SPECIFIED HEREIN OR <br />NO7. THE GRAN7ING OF A PERMIT DOES NOT PftESUh1E TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PROVISION OF ANY OTMER <br />STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY T}IE <br />OWNER OF TNIS PROPERN TO PERFORN TNe �VORK FOR WHICH APPIICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LA1V 1827 RCW AND 296200 WAC. <br />�,v,�,. C,�,�„r,� �. , , , � � ° 1�.�- l03 <br />DEBIT t� CREDIT CARDS ARE NOT ACCEPTED <br />2'ci �588LScSchi��_._ �IJOJd Lb�60 £002-82-1XI <br />