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SITE <br />LOT NO. <br />wcRMIT APPLICATIt�N <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 />TRACT OR SUBDIVISION # <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />E-MAIL <br />NTRAC R A DR S �� � <br />CON7R. UCENSE # <br />USE OFBUILDIKG <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />SinF, (service/badmop/elcJ <br />Back(low prevenler <br />Urinal <br />Orinking founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />I hereby ceritify thal I have read and�`f <br />ordinaces gov�rping ��is type of work <br />to give authority to viQlale or cancel lf <br />conslruclion. That� r� author' ed by <br />Slate Conlractors,L�v �(8.27 (�C�W ar <br />HEAT SOURCE <br />Electric Gas Other <br />r-5-o9 <br />PERMIT # <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Waler heater <br />Gas freplace <br />Gas rango <br />Clothes dryer <br />Range hood <br />Exhausl Tan <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigeralion <br />Nbodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />this applica!�on and know the same te be lrue and wrrecL All provisions of laws and <br />m lied with whelher specified herein or not. The c�ranting of a permit does not presume <br />m f any olher state or local law regula;ing construction or lhe pedormance of <br />r o this property to pedorm the �vork for which applicalion is made and I comply with the <br />Q. �� ( . �� � <br />