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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS PARCEL TAX I.D. # <br />70`i h1%mJrsw, "W 0/no)I o04/,23tx�cOo�{ov <br />LEGAL LOT NO. I BLOCK I TRACTOR SUBDIVISION # <br />DESC. <br />mti,-jj4- mwne WP, <br />TENANT NAME /1, ene l <br />CONTR. LICENSE # <br />CONTACT FOR PERMIT PHONE <br />v y nm>7 <br />r_ueu <br />ab%Pcoils <br />USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br />Electric Gas _ Other 12h, oll <br />WORK DESCRIPTION 0jjgf.LU gr Nf&yoq Td /M;? g) nC--w jtk)jWY1A rS7jMCnu T() <br />6ylly lb (VnnalcpVp7 ) CIO (,f}"b*E TD vympnw lwz ffw'E. <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ Toilet <br />_ Bathtub <br />_ La. story (wash basin) <br />_ Shower <br />_ Kitchen sink & disposal <br />_ Dishwasher <br />_ Clothes washer <br />_ Water healer <br />_ Sink (servioe/bar/mopletc.) <br />_ Backllow prevenler <br />Urinal <br />Drinking Fountain <br />_ Floor drain <br />_ Grease trap <br />_ Roof drains <br />Other <br />NO, I TYPE OF FIXTURE OR ITEM <br />_ A/C — air handling units <br />_ Forced air systems <br />_ Gas piping <br />_ Water heater <br />_ Gas fireplace <br />_ Gas range <br />_ Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump I Jl <br />Unit heater <br />Ratter/� <br />Refrigeration <br />Woodstove <br />Other_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the some to be true and correct. All provisions of laws and <br />ordinancesyyoverning this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to gi 0 hor}�ly to violate or ca cat the provision of any other slate or local law regulating construction or the performance of <br />const Ilion. ThAI I am au/ d by the gymer of this property to perform the work for which application is made and I comply with the <br />rnn rtn . I aw 1B. CW and 7y0 200 WAC. <br />%�/0 <br />1/� <br />