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PERMIT APPLICATION <br />moba 'D"?"-y <br />CITY OF EVERETT PERMIT SERVICES g1eers ilcW 224 Z <br />L <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425.257-8810 FAX 425-257-8857 <br />- <br />SITE ADDRESS PARCEL TAX I.D. Is <br />— <br />PERM11 <br />O. <br />LEGAL �.CT NO. <br />DESC. Z 8 L z C% <br />BLOCK <br />TRACT <br />OWNER <br />ADDRESS <br />_____ <br />ZIP PHONE <br />CmS g�urwCti, iPjc • poifjX1579, Soowd,"a6,ZU/2 <br />TENANT NAME <br />CONTACT FOR PERMIT <br />PHONE <br />C2ar4-NCR Lrta� <br />(YZ� 3'S �j-loon <br />— -- <br />CONTRACTOR <br />CMS <br />ADDRESS <br />1r1»<< As A6oair <br />--- <br />ZIP CONTR. LICENSE a <br />PN?"S) <br />Cw1SSAl 1x08SNf3 <br />3S3 -�oo0 <br />PROPOSED USE OF BUILDING Building Mechanical I Addition HEAT SOURCE <br />PERMIT Combination {R.( Plumbing WORK 1f�1Alteration Electric <br />c F TYPE Demolition I� Sign (TYPE UQ Niw I Gas <br />J +�1% Sprinkler 9 Repair/MainL Other <br />CONTRACT PRICE OF WORK 000 <br />// CITY OF LVERETT LOCAL SALES TAX CODE IS 310S <br />I Lp o � �DO�• L c �� 20� <br />WORK DESCRIPTION Co�+I7>Q i. DNP Ldy STR "6rV&O-C� <br />Cc,.�,sr*A"x NtrW sFQ. — I Bu, a,Ns — Z Li ,rs Wr>•J4 <br />-j-H',ti 0 vml '4 rrl <br />PLUMBING t+�N j,bE j4pf <br />NO. I TYPE OF FIXTURE OR ITEM 7-01'- <br />I WATER CLOSET (TOILET) <br />BATHTUB wI JA4^4 11141111 <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 />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - A/HANDLING 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 />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 R€GULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, THAT 1 AM AUTHORIZED BY THE <br />OWNER PF THIS PROPEPTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT4KC/rORS LAW 1000J227 RCW AND 296.200 WAC. , <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />