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� <br />PL. �MIT APPLICATIO,. <br />CITY OF EVERETT PERMIT SERVICES <br />3200 �;EDAR STREET, EVERETI , WA 98201 <br />425•257•8810 — FAX 425-257-8857 <br />SITE ADDFESS <br />'i�`�'-- si� �r..S, r <br />LEGAL� LOT N0. � I BlO:K I TRACT <br />D[3C.� <br />PARCEL TAX I.D. M <br />GtJGf U�' / � <br />PERMIT N <br />��oS cv�z <br />� ,.��/.:-/l �, :r ����.���,e�C. ,�c.. <br />TENANTNAME CONTpCTNAME PHONF <br />� ia^e � , s.. •/!`_�ti+.An.L� �! 2.i—.2 3 2'�C ..Z 9 V <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE M <br />w�=�,,,v� s otif�„� <br />PMONE <br />� ?s^t t�, <br />I PROPOSED USE OF BUILGING <br />PEHMIT <br />SL'��/ TYPE <br />CONTRACT PRICE OF WORK <br />Building <br />Combination <br />Demolilion <br />Sprinkler <br />WORK DESCRIPTION �}f}-$ � C �I�lw� �� <br />/ F.' L— <br />� NO. I TYPE OF FI%TURE OR ITEM <br />WATER CLOSET <br />BATHTUf3 <br />LAVATORY (WASI1 BASIN) <br />SHOWcFi <br />KITCHEN SINK S DISPOSAL <br />DISHN'ASH[R <br />LAUNDfiY TNNY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREV[NTER <br />SINK �SERVICEi�AR/MOP'ETC.) <br />OTHER _ <br />RMechanical <br />Plumbing <br />C) Sign <br />AJtlition HEAT SOURCE <br />WORK Allerelion n Elactnc <br />TYPE New ,q Ges <br />Fapnir/IAeint. Ll Other <br />CITY OF EVEREIT LOCAL SALES TAX COOE IS 3105 <br />N0. I TY?E OF FIXTURE OR REM <br />A/C – A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />ME7AL �IREPLACE/STOVE <br />fIREPLACE INSEFT <br />GAS PIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHE�i <br />I HEREE3V CERI7IFV THAT I HAVE READ AND EXAMINE� THIS APPUCATION ANO KNOW THE $AME TO BE TRUE ANO CORRECT. ALl <br />PROVISIONS UF L1WS �ND ORIDINACES GOVERNING TH!5 TYPE OF WORN WILL BE COMPLIED WITH WNETHER SPECIFIED HEREIN OR <br />NOT iHE GRANTING OF A PERMIT DOES NOT PRESUM1IE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br />STA7E OR LOCAL LAW FEGULATING CONSTRUCTION OR THE PERFOFMANCE OF CUNSTRUCTION. TNAT I AM AUTHOFIZEO BV THE <br />OWNER OF THIS PPOPERTY TO PERFOFM iHE WORN FOIi WHICH APPLICATION IS �dADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW iB27 RCW AND 29fi200 WAC. <br />