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PERMIT APPLICATtON <br />� CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, FVERETT, WA 98201 <br />A25-267•9810 - FAX �25-257-8857 <br />SREADDRESS <br />.� <br />LEGA LOT N0. BLOCK <br />� � � J � <br />TEN�NTNAME <br />GOMIV1CT011 - <br />PMONE <br />� <br />Pi1070SED USE OF BUILDING <br />COHTRACT PPoCE OF WORK <br />PARCEL TAX I.D. R <br />ii:6Ln� <br />I-a i--�S <br />ERMR I / <br />�/� �- � " � <br />.. �- _. ,� n ' i�., �•�.. 1,��% j.'� . I .�_'t . <br />ICONTACTNAME PHONE , <br />NORTHWEST PERMIT INC, 360 945 2787 <br />ADOfIC]� II� COIRTI UCCN9C � <br />.. i�, . . � .. .. <br />Buddtng <br />PERNIT Combmetbn <br />TYPE Demdlfion <br />Spdnkler <br />mecnamc <br />Plumbing <br />Sign <br />WOfIK DESCRIPiION <br />' . . , . � . ' • ' . . . , � � � <br />f/U. 1 TMt U� FlkTUAE OH 11 tM <br />WATEA CLOSET <br />_ BATHTUB <br />__ LhVAIUMY�Wl�SHtlASIN) <br />SHOWER <br />KITCHEN SINK S DISPOSAL <br />UISNWASHER <br />� _ LAUNDRYTRAY - <br />. _ CLOtHES WASHER <br />URINAL <br />' � DRINKING FOUNTAIN <br />� FLOOR ORAIN <br />� BACKFLOW PREVENTcR <br />� SINK (SERVICE/BARIMOP/ETC.) <br />_ UTHER <br />Atldition <br />Nteration <br />New <br />- RepnirRdainl. <br />NEATSOURCE <br />�n� <br />Oae <br />01her <br />CfTY OF EVERETT LOCAL SALES TA% COOE �8 7106 <br />BO. I IYPt OF FU[fUNG UN It tM <br />_ A!C—NHANDLINGUNITS <br />; FORCED AIR SYST[MS <br />HEATPUMP <br />� UNIT HEATER3 <br />_ CIOTHES ORYER <br />, RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />J FIREPLACE INSERT <br />_ GA6 FIREPI/10E <br />GAS RANGE <br />� GAS PIPING <br />_ EXHAUSTFAN <br />UIHhH <br />I HEREBY CERITFY THqT I HAVE PEAD AND EXAMINED THIS APPIICATiON AN� KNOW THE SAME TO BE TRUE AND CORPECT. ALL <br />PROVISIONS OI' IAWS ANOORIDINACES GOVERNING THIS 7YPE OF WOfiK WILL BE COMPLIED WITH WMETiEF SPECIFlED HEREIN OR <br />NOL TNE GFANTINC OF A PFRMIT DOES NOi PRESUME TO ONE AUTMORIN TO VIOLNTE OR CANC[l TH[ PFOVISION OF ANV OTHER <br />STATE OF I.00AL lAW REGUlAT7N(3 CONSTRUCT1pN OR 7}7E PEiiFORMANCE OF CpJSTRUCi1qJ. TIU�T I AM AUTFIORIZED BY THE <br />ON7JER OF THIS PFOPENtt TO PERFORM R1E 1VOfiK FOR WHICH APPUCATION IS MA�E AND I COMPLY WITH THE STATE <br />CONiRACTOfiS LAW 18.27 RCW ANO 298.200 WAC. <br />, '\ <br />SgnaWreofOwnenContracloN utho�zaC gent Oate <br />