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SITE <br />�� <br />��T <br />rFRnIIIT APP�.IG�+►TivtW <br />CIl'Y OF I=VERETT PERMIT SERVICE� <br />3200 CE!�AR S�REET, EVERETT, VVA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX I.D. # <br />�r`�.�c ��-'. �-� ��`�'"e�� �01� �lc� <br />�� � r OCK TRACT <br />l � fJ 7✓ <br />PER6-0IT # <br />J'Y� ��-a(� <br />� o�Lt � �`� L �� ��tc. [�'�/,' � � ! +:� ���C � � /l?�' ,L ��.�7b `� Z? �3`I S'i� <br />TENANT NAME � CONTACT FOR PERMIT PHONE <br />CONTRACTOR � F�� %�lL� f L t <br />J (�:c.lcp.� /qL <br />PHONE <br />�l5 2 �>l. '- jC� <br />PROPOSED USE OF 6UIL��NG <br />ADDRESS <br />r� i(!S"' llc J:�.:-�� /�a-EC��4. (t c� <br />���2�-t1cuCVzC ��'(. <br />Building Mechanical <br />PERG717 R Combination � Plumbing <br />TYPE Demolilinn � Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK i c,� :;� `-' <br />i <br />WORK DFSCRIPTION <br />ZIP <br />�J�4� iz <br />CONTR. LICENSE # <br />.��f=��/��(, �i����7�� <br />Addition <br />WORI< Altera6on <br />TYPE New <br />Repair/M�int. <br />HEATSOURCE <br />�lactric <br />as <br />Other <br />CITY OF EVERFTT LOCAL SAI_ES TAX CODE IS 3705 <br />����������,r� ��i� '�., �.�,r,���, �r-, a3q� I�-�-�v��nCc_-� <br />) <br />V <br />NO. I TYPE OF FIXTURE OR ITEM <br />V.'HTER CLUSET (TOILET) <br />BATHTU6 <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN 91NK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINI<ING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEiBAR�MOP.�ETC j <br />OTHER <br />� <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — A/HFN�LING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER 4EATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPL/�CE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT : HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME (O BE TRUE AND C(�nRFi;T. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK VJILL BE COMPI_IED 4VITH WHETHER SPECIFIEJ HEP.'eIN OR <br />NOT. THE GRAN7ING nF A PERMIT DOES NOT PRESUPdE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGUL4TING CONSTRUCTION OR THE PERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y THE <br />OINNER nF THIS PROPERTY TO PERFORM1I THE WORK FOR WHICH APPLICATION IS MADE ANO I COfv1PLY WiTH l"HE S"i ATE <br />CONTRP.CTORS LAW 1Q,27� RCW AND Z�('y200 WAC. <br />� <br />DEBIT & CRE71T CAkDS ARE NOT ACCEPTED <br />