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P[ .EMIT APPLICATIC J <br />4:77- CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS �I J PARCEL TAX I.D. # ' ;PR <br />LEGAL LOT NO. BLOCK TR{�CT <br />DESC. I RC F J L� TDll�l< <br />OWNER ADDRESS ZIP PHONE <br />-��1N � 1 'NISI. �I�bhs SOS 3 � Uele�. �Ue��lf 3�3-7/l0l <br />TENANT NAME CONTACT NAME ���[I'� PHONE <br />CONTRAC OR t ADDRESS , + ZIP CONTR. LICENSE # <br />Lq <br />PHONEr �n �_ ii m, �`"' m—I di7ux� 301 1._ H _ <br />PROPOSED USE OF BUILDING ,,,yyy���;777((, Building � Mechanical yyy������((( Addition HEAT SOURCE <br />PERMIT Combination Plumbing WORK Alteration Electric <br />TYPE Demolition Sign TYPE NewGas <br />Sprinkler Repair/Maim. Other <br />I— Imo\ <br />CONTRACT PRICE OF WORK ' _/'' f ✓_�/�_ CC, I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION II �� <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />ATER CLOSET <br />BAVATUBY (WASH BASIN) <br />SHOW) <br />KITCHEN SINN & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREV TER <br />SINK (SERVIC AR/MOP/ETC.) <br />OTHER <br />_ <br />_ <br />_ <br />_ <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP /�µIN�+� D p <br />UNIT HEATERS l �/ <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER - <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAN11NED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS CF 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 THE PROVISION OF ANY OTHER <br />ST6T&GQLXAL tAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE <br />OWNER O IS PRbPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />L�ON"RACT)aR54.AW 18.27 RCW AND 296.200 WAC. _ <br />I�Z <br />