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� <br />P�RMIT APPLICATI(�N <br />CITY OF EVERETT PERMIT SERV'ICES <br />3200 CEGAR STREET, EVERETT, WA 98201 <br />425-257-8810` 7- F�AIX 4Z5-257-8857 <br />'77�4�F b�d0�-O6,�00 <br />� �,• <br />; a' � i,n �— � C. L:.1 <br />i.OT NO. BLOCK <br />PARCEL TAX I.D. # <br />�(' � CX� I -c <br />TRACT <br />C��c��.�uu c� C rc �.E <br />�P RMIT # <br />S // - v�� <br />urrrv�n �� iawrtwo I'M� A-�� ur ` rnvnc <br />f`��G.C�o'. �- :. '^�/Yt�.� NL-'Z'15o�:.0 <br />� � N1.G � �'• `. CO Z 1 � R 5 I�� l `�S �? f ur�v : <br />TENANT NAME NTAmCT FOR P�RMIT PHONE <br />� e�} i1 vv ri �1Z � 299 - of3c.n <br />CONTRACTOR• ' <br />PHONE <br />• � AUDRESS <br />PROPOSED USE OF BUILDING <br />PERMIT <br />j 1_. `l TYPE <br />L <br />CONTRACT PRICE OF WORK � 3U , U V U <br />WORK DE�S�RIPTION <br />I<. U.', A�� f1 <br />NO. I TYPE OF FIXTURE OR ITEM <br />ZIP� CONrR.LICENSEfI <br />ISc�Gc.r� 9 �.iC �= <br />1.., . . � . . 1 ' <br />Buiiding n Mechanical <br />Combination � } Plumbing <br />Demolition � Sign <br />Sprinkler <br />21��{ �" �I"�: <br />�v;�►c I�I <br />WATER CLOSET (TOILET) <br />BATHTUB <br />IAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DiSHWASHER <br />LAUNDRY TRA;' <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR URAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICElBAR/MOP/ETC.) <br />OTHER <br />Addition <br />AlleraUon <br />New <br />Repair/Maint. <br />HEATSOURCE <br />�Electric <br />Gas <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />% �� �/�� <br />� -� z � � <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C —A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUA1P <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAPAINED THIS APPLICATION AND KNOW THE SAME TU 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 PERAIIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW.REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROP RTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH TI'e STATE <br />CONTRACTORS LAW 'I 27 RCW AND 2 C � <br />r'' 9�- i � � �� � <br />� . .. : � : . 1- � Ci � i\_ l ' '. V l <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED ~�(„� O/��' <br />