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I <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 1 , 3 -.02 <br />SITE ADDRESS EJElx-fi PARCEL TAX I.D. # PERMIT # <br />Q- 2 o 2 P- ER -A VE -4 9, wA <br />LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION # <br />DESC. <br />rah nLi WArr--h s 2t) 1 211sK s+ s.0 42-S7. 3,VY 4S S' 23 <br />TENANT <br />, NAME CONTACT FOR PERMIT PHONE 264. !j}_��jL <br />L1-( IST �JA' S N-AILS PETER /-7\k'D-4 E-MAIL Pe d-cvy l ti 60k U I . <br />VVI\IRIV IVIA CJJ VII IILI!' rl1V G <br />�'3� N� Ycyv�p�e1iH� ��dUS -FA B6LT, FRD.S. I il?-ENToA/ 2o6.77ri &III - <br />CONTR. LICENSE # J9 <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />SIW <br />WORK DESCRIPTION <br />_ Electric _ Gas _ Other <br />14r36� <br />.1NS "IALk- Oo1E t� IUQ-TEAM LE'ff�ER OOJ 1.0hLL T--^CIA I1J-ff2oIJT <br />a?J r s voi <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Root drains <br />Other ?Sn. <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ FdC - air handling units <br />_ Forced air systems <br />_ Gas piping <br />_ Water heater <br />_ Gas fireplace <br />_ Gasrange <br />_ Clothes dryer <br />_ Range hood <br />_ Exhaust fan <br />_ Heat pump <br />_ Unit heater <br />Boiler <br />_ Refrigeration <br />_ Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces 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 stale or local law regulating construction or the performance of <br />construction. ' hat I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate Contractors Law 18.27 RCW and 200.200 WAC. <br />94 <br />