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�.:RMIT APPLICAI'I� N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, b`:A 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS <br />� a. � _7 t�. p t" �.J`'�j�' <br />LOT NO. I BLOCK <br />DESC. <br />I (� ��� <br />I TENANT NAh1E <br />�.c,h�-c-� S <br />CONTRACTOR <br />�d� � ��� <br />PHONE <br />(�3U0� `C�� V� _ `'� S�i^a <br />PROPOSED USE OF BUILDING <br />���» �� <br />PARCEL TAX I.D. N <br />GO-7 c�e; a� �^�c�0 <br />TRACT <br />CONTACTNAME � PHONE <br />C�c-e5 S'�cnw�o,) (gt�o: <br />ADDRESS ZIF <br />� � �a � H...� ��. <br />�y��,�� ,� �,��� <br />Bui�ding Q Mechanical Addition HEAT SOURCE <br />PERMIT � Combination I) Plumbing WORK R Alleralion � Electric <br />TYPE Demolition � Sign TYPe f5� New � Gas <br />Sprinkler LJ Repair/Maint. � Other <br />q <br />CONTR.UCENSEN <br />-Z-ex�+�c.PF� <br />�'o �iU�Gc <br />CONTRACT PRICE OF WORK `'a�- <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />WORK DESCRIPTION ` <br />C_c�\��c;� ���2� �S� �Cdl„ �.._.. C�C�t��. <br />TYPE OF FIXTURE OR REM <br />� _ W R CLOSET <br />� BATH � <br />' LAVATO (WASH BASIN) <br />_ SHOWER <br />_ KITCHEN SINK ISPOSP <br />� _ DISHWASHER <br />j _ LAUNDRY TRAY <br />i — CLOTHES WASHER <br />i_ URINAL <br />_ DRINKING FOUNT <br />_ FLOOA DRAIN <br />_ BACKFLOW P VENTER <br />SINK (SE CE/BAR/MOP/ <br />OTHE <br />TYPE OF FIXTURE OR ITEM <br />-A/HANDLING UNITS <br />iCED AIR SYSTEMS <br />HEAT MP <br />_ UNIT HE RS <br />CLOTHES D E <br />RANGEHOOD <br />WATER HF.ATER <br />METAL FIREPLAi <br />FIREPLACE INSE <br />;AS FIFEPLA <br />GAS RANG <br />_ GAS PIP G <br />EXH T FAN <br />i HEREBV CERITIF'r'HAT I HAVE REA� ANO EXAPdINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PFOVISIONS OF V.NlS AN� ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPEGFIED HEREIN OR <br />NOT. THE GFANTIMG OF.A PERId1T DOES IJOT PRESUtdE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATc OR LOCAL LPVJ REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEP OF THIS PFOPERT/ TO PERFORM THE WORK FOR WHICH APPLICATION IS IdADE AND I COMPIY WITH THE STATE <br />CONTRACTOFS LAW 18.27 RCW AND 296.200 WAC. i i <br />