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■� <br />P.''RMIT APPLICATI� N <br />CITY OF EVERETT PERMIT S�RVICES <br />3200 CEDAR STFEET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257•8857 <br />SITE ADDRtSS PARCEL TAX I.D. M f PEFMIT N <br />! �� �%� C SL—�:�`/r' –cxr� Olc� �I �c,�c�-r,,ia <br />LEGAL LOT N0. BLOCN <br />DESC. �� � <br />� <br />NAME <br />�nr � <br />i ��f (. ����� � <br />ADDRESS <br />/1�-fF 5� CYSk�✓1/-� <br />_ L,��t�«1 �_H . , <br />PHUNE <br />ICONTACTNAME <br />CONTRACTOR � A�ORESS <br />lrG�:r� w�r ,�/�.- :��_ <br />PHONE <br />��Is — �-'�y �s7? <br />PROFOSEn USE OF BUILDING I <br />_S� � PERMIT <br />TYPE <br />CONTRACT PNICE OF WORN <br />W V�i4 UtSGqIPTION <br />s�-,� � <br />/��,� -� <br />PLUMBING <br />NO. I TVPE OF FIXTUPE OR ITEM <br />� �_ wnItHCLOSET <br />' �!,"i HTUB <br />� � LAVATORV (WASH BASIN) <br />I _L uHOWER <br />/ KITCHEN SINK 8 DISPOS�L <br />' � OISHWASHER <br />I — LAUNDRY TRAY <br />J__ CIOTHES WASHER <br />URINAL <br />' DRINKING FOUNTAIN <br />; _- FLOOF DRAI� <br />___ BACKF�OW PHEVENTFR <br />_— SiNK �SERVICF./BAR/MOP�[�rC ) <br />_- OTHER_ <br />��� <br />��: ' <br />21P CONTP. IICENSE N <br />_ ���r,�,����,��- <br />f�1 Bulldiny n Mechnmcal I n Add�l�on HEAT SOURCE <br />pI�( Cornbinalion H Plumbiny WORK �-� Allernlion I� F�uctric <br />�,J Damolilion V Sign 7YpE K� New 1I�q Gae <br />U Sprinklctr U Rapair/Mamc V Olhar <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS 3 t05 <br />NO. TVPE OF FIXTUiiE OR ITEM <br />"- A/C - NNANDLMG UNITS <br />� FOFCED �IR SYSTEMS <br />= HEAT PUMP <br />�-" UNIT HEATFFS <br />�CLOTHES DRYER <br />_ RANGE HOOD <br />—J_. �'/ATER HF.ATER <br />— METAL FIREPLACE/STOVE <br />- FIREPLACE INSEF7 <br />/ GAS FIREPLACE <br />�GAS RANGF <br />GAS PIPING <br />_ [XHAUSTFAN <br />_ OTHER <br />i HER[BV CERITIFV THAT I HAVE READ ANO EXAMINED THIS APPUCATION AND HNOW THE SAME TO BE TRUE AND COFRECT. ALL <br />PROVISIONS OF I.AWS AND ORIDIhACES GOVERNING TNIS TYPE OF WORK WILL pE COMPLIED WITH WNETNER SPECIFIED HEFEIN OR <br />NOi iHE G17ANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTNORITV TO VIOLATE OR CANCEL THE PROVISION �1F ANV OTHEH <br />STAiE OF LOCAL LAW qEGULATING CONSiRUCTION OR THE PERFORMANCE OF CONSTiiUCT10N THAT I AM AUTNOR12ED BV THE <br />OW��f:R OF HI$1PIiOPERTV Tp pERFORM TI1E WORK fOF WHICH APPLICATION IS MADE ANO I COAIPLV WITIi THE STAiE <br />C0�+1RA��i�AW�p7 RCW f�ND 296 200 WAC <br />