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� <br />`� <br />S�TE ADDRESS <br />P�.,�MIT APPLICATIG.� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />G�s' �1 <br />r��� `�` <br />PARCEL TAX I.D. # PERMi7 � � <br />_c�J-`. i. .Sit� 24`f;'s'/4'!i '•c�.�Z3Gc. C� �1'L�� <br />lOTNO. n I BLOCK I TRACT <br />, <br />ADDRE <br />� .✓i'-'.. r .'�' �� �i . .7Y� ��'. �L v � <br />H�-w l GiE:,,.N <br />c <br />TENANT NAME CONTIiCT NAME � PHONE <br />;.;',�-rC, �<��T/ �''���';: `1zs--,}3�.-C.�7�� <br />CONTRACTOH ADDRESS �� ZIP CONTFi. LICENSE M <br />.1—�S� WrN/��'si15�5S-�� c_- <br />PHONE � <br />PROPOSED USE OF BUILOING D Building � MeChanical I �tlq�i�on I HEAT SOURCE <br />// PERM1IIT J.�) Combmation Pl9mbmg WORK ��nernuon n Eloctnc <br />�l'- ' TVPE � Demolition Si n IYPE New F� Gas <br />Spnnklar Nep�irldain�. L/ Other <br />ICONTFACT PRICE OF WORH <br />,� WOflKDESCRIPTION � j �ti � <br />'i N0. � TVPE OF FI%TURE OR IT[M <br />� WAiER CLOSET <br />� BATHTU� <br />�� LAVATORY (WASH BASIN) <br />� SHOWER <br />� KITCFIEN SINK 3 DISPOSAL <br />1_ DISHWASHER <br />� LAUNDRY ?RAY <br />�f_ CLOTHES WASHER <br />URINAL <br />DFINKING FOUNTAIN <br />FLOOR DRAIN <br />�ACKFLOW PREVENTER <br />SIiJK �SERVICE: BAWMOP/ETC.) <br />OTHER <br />� <br />CITY OF EVERETT LOCAL SALES TAx CO�E 15...05 <br />MECHANICAL <br />NO. I n'PE OF FIXTUFE OR ITEM <br />C-' q!C-.4/HANGJNGUNI7� <br />�_ FORCED AIR SYSTEMS <br />��� HEATPUMP <br />UNIT HEATERS <br />� CLOTHES DRYEH <br />� RANGEHOOD <br />�WATER HEATER <br />METAL FIREPLACE/STOVE <br />� FIREPLACE �NSERT <br />� GAS FIREPLACE <br />_� GAS RANGE <br />� GAS PIPING <br />_� EXHAUST FAN <br />OTHER_ <br />I HEREBV CERITIFY THAi I HAVE READ AND EXAM1IINED THiS APPLICATION AND KNOW THE SAME TO BE TRUE AtJD COFRECT. ALL <br />FPOVISIONS OF LAWS AN� ORIDINACES GOVERNING TNIS'.'iPE OF WOfaK WILL BE COM1IPLIED WITN WHETHER SPEGFIED HEREIN OR <br />NCT THE GRAMTING OF A PERMIT nOES NOT PFESUh1E TO GI\'E AUTHORITV TO VIOLATE OR CANCEL THE PROVISiON OF ANY OTHER <br />S7ATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNEF OF iHIS PROPERTY TO PERFOq61 THE WORK FOR WHICH APPLICATION IS MADE ANO I COMPLY WITH THE STATE <br />C0�17RACTOPS LA\N 18.27 RC'N AND 296.200 WAC. <br />i�Z <br />