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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 ADDRES PARCEL TAX I.D. # <br />LTEGAL LOT NO BLOCK TRACTOR SUBDIVISION# <br />TENANT NAME r r c I CO- T1 T FOR PERMITPHONEPHONE Lgl.S 3() S kJ 6� <br />Y"nlOr kv j ICiJ OF SY10 ,Q�SLr IH %c*S 4 1 E-MAIL <br />CONTRACTOR AIJUKLS ITY IP P n; 42,53613� <br />S� q <br />CONTR. LICENSE # Jarto sP 33 161 L <br />USE OF BUILDING <br />m I'Q e� <br />WORK DESCRIPTION <br />ocir +Y-,� <br />/ '77i't <br />NO. I TYPE OF FIXTURE OR ITEM <br />HEATSOURCE <br />_ Electric _ Gas __ Other <br />CONTRACT PRICE OF WORK <br />4()O.o0 <br />S06A1 <br />I-IoT ld VV4*-Y" Wy%tC- t V"vr- <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 heater <br />Sink (service/bartmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other Ill <br />— <br />— <br />_ <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <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 <br />Unit heater <br />Boller <br />Refrigeration <br />Woodstove <br />Other <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />-j_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify 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 specked 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 property to perform the work for which application is made and I comply with the <br />State Contractor; Law 18.27 f�GW and 296.200 WAC. —' <br />