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RMIT APPLICATION moba <br />CITY OF EVERETT PERMIT SERVICES gp,s ic* Z7-43 <br />3200 CEDAP STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425.257-3857 <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT a <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. 3 <br />OWNER ADDRESS ZIP PHONE <br />Cry1s 40"'A 13uiWek, /^Je . 08, /57y S�of/o.-I,Jy,c�l.{ �f�291 �z r) :t fodu <br />TENANT NAME CONTACT FOR PERMIT <br />PERMIT PHONE <br />CR4/ct /I�j(Aao,-J zTti /000 <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE # <br />C-M-r IA�r as A.6dLr Crv1xsAl �ttog,nv3 <br />, P� NE-s_ <br />j 393-g000 <br />PROPOSED USE OF BUILDING <br />Building <br />Mechanical <br />lIddlhOn <br />HEAT SOURCE <br />PERMIT <br />Combination <br />Plumbing <br />WORK <br />Alteration <br />Electric <br />S c Q <br />T/PE <br />Demolition <br />Sign <br />TYPE <br />New <br />Gas <br />,\ <br />Sprinkler <br />2epartiMaint. <br />Other <br />CONTRACT PRICE OF WORK <br />/00' r000 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />C u✓ 3 emu-'-r v r j S Ic k <br />PLUMBING ---� <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. 1 TYPE OF FIXTURE OR ITEM <br />3 <br />_ <br />I <br />_I <br />WATER CLOSET (TOILET) <br />BATHTUB W/ I NMi 1 <br />LAVATORY (WASH BASIN; <br />SHOWER <br />KITCHEN SINK 8 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 />1 <br />J_ <br />I <br />_ <br />= <br />T <br />A/C - AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I <br />_ <br />_ <br />_ <br />_ <br />_ <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 R GULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER THIS PROPE TV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE S TATE <br />CONTIORS LAW 1 7 RCW AND 296.200 WAC. - <br />5-�o <br />Date <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />