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LOT <br />PERM�'T APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STFEET, EVERET7, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />p,,�� l/o-or� <br />TRACT <br />PARCEL TAX I.D. N <br />PEPMIT N <br />G ���� -/.�/t0 <br />TENAN� ��V.O�� 10 �� � i�Caf�► T 1'l�l, �, 9gahs 4�SPG'l E"�laS� <br />i 1'�C <br />CONTRACTOR ADDRE39 ZIP CONTR. LICENSE � <br />PHONE <br />PROPOSED USE Of BUILOING <br />Bullding <br />PERMIT � Combinelfon <br />TYPE Domollllon <br />Sprinkler <br />Mechanical <br />Plumbing <br />Slgn <br />CONTRACT PRICE UF WORK .'� / p�� �I <br />WOIiK DE9CRIPTION A��� ,L �� 1�� 1 �` <br />�v 7 oL <br />��' ` � <br />NO. � TVPE OF FIXTURE OA REM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH OAS�N) <br />SHOWER <br />KITCHEN SINK 3 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNIAIN <br />FLOOR DRAIN <br />BACHFLOW PREVENTER <br />SINK (SERVICE/BAR�MOP/ETC.) <br />OTHEH <br />n Addflion <br />�-"S Allerallon <br />H New <br />LJ RapelrlMeint. <br />HEATSOURCE <br />� Electrk <br />f�4.0ae <br />�l, Olhor <br />CRY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />�`� �^1 ' <br />G,�RV►��' <br />NO. I TVPE OF fll(TUAE OR�IT�JN � <br />A/C — A/HANDLIN6 UNITS <br />FORCED AIFi SYSTEMB <br />HEAT PUMP <br />UNIT HEATEf;S <br />CLOTHES DRYER <br />RAN�EFi00D <br />WATER HEATER <br />ETAL FIREP TOVE <br />F PU1C . ERT <br />GA PLAL'E �Q r,��1�C� <br />d A E <br />S PIPIN <br />EXHAUST FA <br />OTHER <br />I HEFEBY CERITIFV TNAT I HAVE READ A' ) E%AIdINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDI� IACES GOVERNII�G THIS TVPE OF WORK WILL BE COMPLIEU WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GRANTING OF A PEPMI7 DOES NOT PRE511ME TO GIVE AUTHOPIIY TO VIOLATE OR CANCEL iNE PROVISIUN OF ANY OiHER <br />STATE OR LOCAL LAW PEGULATING CONSTHI�CTIOP� i.H TI �: PERFORMANCE OF CONSTRUCTION. THAi 1 AM AUTHORIZED BY THE <br />OWNER OF iHIS PROPERIY TO PERFORM THE WORK rOR WHICH hPpLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRA�TORS LAW 18.27 f1CW�AN� 298.200 WAC. <br />D— I/� �OI <br />