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SITE <br />�cRMIT APPLICAT��1N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />. TAX I.D. N <br />._�i <br />LEG� LOT NO� � I BLOCK I TRACT I.1 O�_/� _ O U <br />DESC. i n -F L - <br />CONTRAGTOR Ory��(�/ <br />`�l�l �' �l. <br />PHONE <br />PROPOSED USE OF BUILDIN6 <br />�\ 1�, ��rna �y <br />CONTRACT PRtCE OF WORK ^- <br />WORK DESCRIPTION ��4� (�(�` <br />Np, I TVPE OF FI%TURE OR ITEM <br />� <br />WATER CIOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHFN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKPLOW PHEVENTER <br />SINK (SERVICEIBAWMOPIETC.) <br />OTHER_ _ _ _— ._ <br />ADDRESS <br />uilding D Machanical <br />PERMIT Cambinelion U Plumbing <br />TVPE DamdiUon U Sign <br />Sprfnkler <br />CONTR. LiCENRE � <br />�N (JSi� H <br />Atldilbn <br />ai�reu� <br />Now <br />RopelrlMelnl. <br />HEATSOURCE <br />ElecWc <br />Gae <br />Othar <br />CITY OF EVERETT LOCAL SALES TA]c cout �s aiw <br />���z47 <br />NO. I TYPE OF flXTURE OR ITEM <br />A/C - AIHANDLING UNITS <br />FORCED AIR SY3TEMS <br />HEAT PUMP <br />UNIT HEA1 ERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATFR <br />METAL FIREPLACEISTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />E%MAUSTFAN <br />I HEREBY CERIiIFV 7HAT I HAVE REA� AND El(AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE OF WORN WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT iHE GRANTING Of A I�ERMIT DOES NnT PRESUME 10 GIVE AUTHORI7Y TO VIOLATE OR CAN':EL THE PROVfSION OF ANV OTHER <br />ST TE OR AL LAW REGULATING CONSTRUCTION OR 7HE PERFORMANCE OF CONSTRUCTION THAT I AM AUTHOR12ED BV THE <br />pW O HIS f'ROf'ERTV TO f'ERFORM THE WORK FOR WMICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT� R9�AW 1B 27 RCW AND 296 200 WAC. <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />