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SITEADDRESS) <br />LEGAL LOT NO. <br />DESC.r <br />I OWNER <br />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 />PARCEL TAX I.D. # <br />_ r n d - a .. <br />BLOCK 1 TRACT OR SUBDIVISION # <br />C3 . 7 —D <br />PERMIT # <br />:i It L /11;c/l I� i�icon act <br />TENAN r NAME CONTACT FOR PERMIT PHONE <br />7 <br />(G) J, E-MAIL <br />COONIKAAUI J S /ADDRE— l 1 7E — <br />QCn,a ell m I �V 5 , t r� 5 L. <br />CONTR. LICENSE <br />USE ' BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric Gas Other <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow 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 />_ <br />_ <br />Forced air systems <br />Gas piping <br />I_.� •� <br />Water heater <br />Gas fireplace <br />/Q <br />I <br />�IfU <br />_ <br />_ <br />Gas range <br />t✓ J <br />� <br />= <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />U <br />_ <br />Heat pump <br />_ <br />Unit healer <br />_ <br />Boiler <br />_ <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws rrnd <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this properly to perform the work for which application is made and I comply with the <br />State Contracto(s ).aw 18.27 RCW,aand 296.200 WAC. <br />