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SITE ADDRESS <br />�7�Y.� �n� 5� <br />LEGA LOT NO. <br />TENANTNAME <br />CONTFjACTOR <br />�%� � ��lG • <br />PHONE � <br />PROPOSED USE OF BUILDING <br />� �- (2 <br />CONTRACT PRICE OF WORK <br />PERMIT APPLiGATION <br />CITY OF EVERETT PERM17 SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />BLOCK <br />_ % <br />`�U <br />TRACT <br />PARCEL TAX I.D. # <br />FOR <br />i3a�c �3�70' �«� r�i7�3P <br />Building Mechanical <br />PERMIT e Combination R Plumbing <br />TYPE � Demolition � Sign <br />U Sprinkler <br />PERMIT # <br />�d� - �-,� 13' idp <br />PHONE <br />CONTR. LICENSE # <br />r¢/'�//1�#'� U31 <br />�Addition <br />Alteredon <br />N,=w <br />Repair/Maint. <br />HEATSOURCE <br />�Eleclric <br />Gas <br />Other <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />WORKDESCRIPTION , U� G ��� �C� r �1 � <br />�� .��a� � ti\ `�f�h <br />��c.wwl,l�LOli <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOW ER <br />KITCHEN SINK � DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVFNTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />NO.. I TYPE OF FIXTURE OR ITEM <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GASRANGE <br />GAS PIPING <br />EXHAU51'FAN <br />OTHER <br />I HEREBY CERITIFY THHT I HAVE READ AND EXAMINED THIS APPL�.CATION 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 />IJOT. THE GRAN`ING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF APJY OTHER <br />OWNER OF �H AL - PERTM�TPNCyC RM THE WORK FOR WHICH APPLICAT ONFS MADE AND I� ONPLY W TH THE S�ATE D BY THE <br />CONTRAC'G�1 W 18.2' �D Y96.200 WAC. <br />DEBIT & CREDIT CARDS AR[ NOT ACCEPTED <br />