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RMIT APPLICATI�N <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 />i �z S!/�i�/ � <br />LEGAL LOTNO. BLOCK TRACT <br />DESC. �, _ „ <br />PARCEL TAl( I.D. # <br />� /G/� OL / v � /2 /I�6� �✓/L /'1 in.�Ta.J, �`l v�I/YUCK /[ T+�a L✓ d <br />TENANT NAME CONTACT FOR PERMIT PHONE ��_5 <br />• �D�r/G� .3/� i�/e.QsC '�ZS y� X 2�i8 q <br />CONTRACTOR <br />��Lr- —aa..✓e: rc <br />PHONE �z j 77 3 � �6I <br />PROPOSED USE OF BUILDING <br />� : is/G E %/J/7 / L� <br />ADORESS <br />��- ,g.t� e �� <br />Building Mechanical <br />PERMIT Combinalion Plumbing <br />TYPE Demolilion Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK f��/��NO La <br />WORK DESCRIPTION <br />/1 v � i T/c .cf <br />NO. I TYPE OF FIXTURE OR ITEM <br />ZIP CONTR. LICENSE M <br />y�AddiOon <br />I--1 PJteratlon <br />H New <br />U RepalNMaint. <br />HEATSOJRCE <br />�ElecUic <br />Gas <br />omer <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3705 <br />��f2 l�CS�O�n�GE <br />�� X � � <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS,,Qx <br />HEATPUMP . <br />UNIT HEATERS <br />CLOTHES DRYER <br />R4NGEHOOD <br />WATER HEATER <br />METAL FIREPLACEiSTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />���� r�lu c� <br />1 HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TI1E SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TFiE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAIN 18.27 RCW AND 296200 WAC. <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />