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SITE <br />LOT NO. <br />NAME <br />CONTRACTOR <br />�rERMIT APP�ICA'�iON <br />CITY QF EVER�TT PERMIT SERVICES <br />3200 C�DAR STREE f, EVERETT, WA 98201 <br />425-257-8910 - FAX 425-257-8857 <br />� e ocK <br />PHONE �AKE �tg /� � � <br />�,�.�y <br />PROPOSEO USE OF BUILDING <br />I /�_— <br />CON7RACT PRICE OF WORK <br />WORK DESCRIPTION <br />NO. I TYPF OF FIXiURE OR ITEM <br />WATER CLOSFT (TOIL.T) <br />BATIi?UB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITGHEN SINK 8 OISPO ;AL <br />DISHWASHER <br />LAUNDRY7RAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING fOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINh �SERVICE/BAR/MOP/ETC.) <br />OTHER <br />PARCEL TA7( I.D. K <br />r•io- a,-. �.r. <br />GONiACTFOR <br />Le/L�/=/_ ! <br />ADDRESS <br />f'� %�� - ac%�- <br />GZ) �P RMIT N <br />03 /� D' y <br />PHONE <br />'�� 6S6-u�'d'f <br />CONTR. LICEf{88E,N0� <br />cXp�2ws li� I <br />(�GSTF�I� q�ySH <br />Bullding MechanlCel �� Addlllon HEAT90URCE <br />PERMIT � Combinetion � P�umbing IWORK � Alteretlun � Eleclrlc <br />TYPE Demolilion Sign TYPE Naw Gee <br />Sprinkler Repalr/Melnt Othar <br />CITY OF EVERET7 LOCAL SALE9 TNf CODE 18 710� <br />FJ <br />aa��� <br />MECHANICI � <br />N0. � TYPE OF FIXfURE OR ITEM <br />A!C — A/HANDLING UNITS <br />FORCFD AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CL07HES DRVER <br />RANGEHOOD <br />WATErZ HEATER <br />MFTAL FIREPLACE/STOVE <br />FIF2FpLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST F;,� <br />OTHER <br />I HEREDV CERITIFY THAi I HAVE READ AND E%AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING TM�S TYPE OF WURK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A P[RMIT DOES NOT PRESUME TO GIVE �:1THORITY TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br />STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR 7HE PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY TME <br />OWNER pF�THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MA�E AND I COMPLV WITH THE STATE <br />CONTRAQ�QRS LAW �B�.T RCyJ AND 2�962�'WAC. / / <br />� � � � � <br />____ y_ _ ......, %L <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />