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srre <br />LOT N0. <br />TENANTNAME <br />' o�EF�MiT APPLIC/�,'� �ON <br />�CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, 1NA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />Vv� � <br />TRACT <br />AODRESS <br />�10 IIV� <br />I CONTACT <br />__�i� <br />ADDRESS <br />a <br />\1 <br />��J ��,�-D�� <br />PERMIT k � <br />��'� '(7�� <br />PHONE <br />�?���,���,� - �,q�� <br />PHONE <br />- � <br />CONTR. LICENSE q <br />P90POSED USE OF BUILOING 9uilding ��r))) Me�anical �� Addiiion I HEAT SOURCE <br />PERMIT ' Combination � Plum6ing WORK Al:eration I�','�( Electric <br />TYPE Demolition Sign TYAE New �2Sj, �as <br />Sprinkler � Repair/MainL L� Other <br />CONTRACT PRICE OF WOFlK CITY OF EVERE7T LOCAI. SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />� F r� . <br />C���� �_ a�3 � � <br />NO. I TYPE OF FIXTURE OR ITEM <br />� WATER CLOSET <br />_2 BATHTUB <br />.� L\VATORY (WASH BASIN) <br />SHOWER <br />� KITCHEN SINK & DISPOSAL <br />� DISHVJASHER <br />LAUNDRY'fRAY <br />� CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLGOR DRAIN <br />BACKFLOW PREVENTER <br />_ S1NK (SERVICE/BAPoMOP/ETC.) <br />NO. I TMPE OF FIXTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEATPUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREP; 4CE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER_ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME Tn BE TRUE AND CORRECT. ALL <br />PROVISIONS Of" LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE CO�dPLIED WITH WHETHER SPECIFIE� 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 />STATE OR �OCAL I.AW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE <br />OWNER OF HIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT�7AC i R�. LA 7.8.27 RCW AND 290.200 WAC. ' <br />\���.C� � o ������ 0 I.A�1��\�. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />