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1-ERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257.8810 - FAX 425.257-8857 <br />SITE ADDRESS /-J 2 - L C P� , fE. PARCEL TAX I.D. M <br />q..� PERMIT M <br />_C—'cSeF%T , w,f. 9fr.ZO) I I nn, <br />LEGAL LOT NO. I BLOCK I TRACT <br />DESC. <br />Co <br />TENANT <br />CONTRACTOR <br />SM /� C 0 n/1i�uc7X� A/ <br />C,'? /�/. SE <br />CONTACT FOR PERMIT <br />ADDRESS <br />/OF 27- 2/J .0P. -Vc, <br />wr. e7k2o_� 0z -1 D-a � <br />PHONE <br />ZIP CONTR. LICENSE n <br />/�Fi M l <br />,, 12 - 337076 VFv(�21c'1S' w}, q ZO <br />PROPOSED USE OF BUILDING <br />Building Mechanical <br />Addition <br />HEAT SOURCE <br />PERMIT <br />IIjU-((( Combination Plumbing <br />Demolition Sign <br />WORK P Alteration <br />TYPE New <br />Iapalr/Melnt. <br />ElectricTYPE <br />Gas <br />Sprinkler <br />RI— <br />Other <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />/PCPLAceJ ftf-f7fe ((-"Cc1k1C) <br />NO. I TYPE OF FIXTURE OR REM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. I TYPE OF FIXTURE OR ITEM <br />AAi - A/HANULING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />_ RANGE HOOD <br />L WATER HEATER <br />METAL FIREPLACE/STOVE <br />_ FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATINP CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT i AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERT 0 gERFfgM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTF�T&QS LAW JB.�rRCJA/ANq'286'.200 WAC. <br />64" hyA 0 3 <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />