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� <br /> PEt2MIT APPLICATIO�I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS #��- �'03 PARCEL TAX I.D.# P MiT# <br /> I� I�(+I� �,r�. S E D Z-G�13 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS ZIP PHONE <br /> TE�AiT�NCAMEI��� CONTACT FOR PERM�T PHONE <br /> �l��� IST I � � K . C��ev� C�-s�) q�-�—36� <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> s�yN ��vYs i b.�b ,. �(�� r� �� � a -�y_ ��3 sr�N�c�a��}- <br /> PHONE ����EVY�I t..i Lt�� ��, �"� <br /> PROPOSEO USE OF BUILDING pERMIT � Sprink�ln ffion � Plumbing al WORK �.-[ Repar�Maint. HEAT SE eRtric <br /> TYPE D2moliti0n Sign TYPE �j New Gas <br /> �� Other <br /> CONTRAC7 PRICE OF WORK � �S�` m CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> WORK DESCRIPTION <br /> J��i y�,�9�1 S'-e�{--- �- G��aw,�.,e( �e H-e�— S �� . <br /> u <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A�'HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP ' <br /> SHOW ER UNIT HEATERS I <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE�IOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT i HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE 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 PERNIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REG LATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BY THE <br /> OWNER OF THIS PROPEFj TO PERF M THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRAC �. RCW AN 96.200 WAC. /�� <br /> 5 / o <br /> Signatu of 0�e/Contractor/Authorized Agent Date �/L <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />