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i <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVCRETT', WA 98201 <br /> 425-257-8810— FAX �125-257-8857 <br /> SITE ADDRESS �, PARCEL TAX I.D.# penrsir tt <br /> �-r�J o CJ�^ .� P��I v3� c3j - <br /> LEGAL LOTNO. BLOCK TRACT <br /> -. <br /> DESC. <br /> OWNER ADDRESS ZI? PHONE <br /> TENANTNAME CONTACTFORi'ERMIT PHONE <br /> ��c� A � ��,�,� � z t=G.i2v► �� �_ �z-�1��dzCcA�m�l�t`p�� � <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# ��r <br /> PHONE <br /> PROPOSED USE OF BUILDING Building f� Mec�:anical AdGition HEAT SOURCE <br /> PERMIT B Combination �_� PlUmbing WORK R Alteralion � Electric <br /> TYPE D Demolition LJ Sign TYPE D Ivew Gas <br /> U Sprinkler U RepaidMainL Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES T!U(CODE IS 3105 <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTE�"S <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> � SINI<(SERVICE/BAR/MOP/ETC.) _ EXHAUSTFAN <br /> OTHER OTHER <br /> I HERE6Y CERITIFY THAT I HAb'E ReAD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE P.ND CORRECT. ALL , <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COPAPLIED WITH WHETHER SPECIFIED hIEREIN 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 REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUiHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR VJHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS L1W 1827 P,CW AND 9�200 WAC. <br /> / <br /> I � <br /> Signatur�of OwnerVC ntractodAulhonzed Agent Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED I <br />