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� <br />�tRMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE7T, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SI7E ADDRESS �i l.lCF"Q-N� LUA -� � PARCEL TAX I.D. M ' I 2ERMIT 8 � <br />TENANT NAME <br />Un e Ccu�y <br />CONTAACTU� <br />PHONE <br />S <br />w ^� 2 <br />PROPOSEU USE OF BUILDING <br />���,�.( ��s � de neE , <br />`7iN(�1,� F4H�c,Y 1�5, <br />CONTRACT P510E OF WORK � <br />WORK OESCRIPTION <br />�o rc {� <br />NO. I TYPE OF FI%TURE OR ITEM <br />TRACT <br />ICONTACTNAME <br />dwner"z <br />ADDRESS <br />Building <br />PERMIT � Combination <br />TYPE Demolition <br />Sprinkler <br />� <br />RMechanical <br />Plumbing <br />D Sign <br />�.� ��'' - �� <br />PHONE �� �.�j� <br />wA . ��t,3z <br />PriONE <br />Y?S- 7�-6 7 Q 0 <br />ZIP CONTR. LICENSE M <br />Addition HEA'f SOURCE <br />WORK Alteration �t Electric <br />TYPE New � Gas <br />RepaidMainl. Olher <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />W/�ir�S ��oC1ii) � ^%�'{- �Yc� C�t�k ot...d.Cli-FiCN. <br />WA7'ER CLOSET <br />BATE!TUB <br />LAVAI'ORY (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 />`� I N�• I n'PE OF FlXTURE,OR REM <br />_ A/l:—A/HANULIN(aUNITS <br />_ FORCED AIR SYSTEMS <br />HEAT PUNP <br />_ UNIT HEATERS <br />_ CLOTHES DRYER <br />_ RANGEHOOD <br />WATER H[ATER <br />_ METAL FIREPLACE/STOVE <br />_ FIREPLACE INSERT <br />_ GAS FIREPLACE <br />_ GASRANGE <br />_ GAS PIPING <br />_ EXHAUST FAN <br />_ OTHER <br />I HER[BY CERITIFY TH' �� I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS ;ND ORI�INACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHEP SPECIFIED HEREIN OR <br />NOT. iHE GRANTING ��F A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIUN OF ANY OTHER <br />STATE OR LOCAL LAVY REGUI�ITING CONSTRUCT�ON OR THE PERPORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICP-ION IS MADE AND I COMPLY WITH THc STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />