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425-252-1666 CMHEATING <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREl'f, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />a.m. 07-08-?014 3/5 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 8 PM —� _�_�Y <br />SITE ADGHESS _ __ � I __ PAHCF.y TAX I.D. # � PERMIT k <br />LOT N0. <br />OESC. <br />�hL <br />USE OF BUILOING <br />BLOCN <br />�►k�5 <br />OR <br />HEATSOURCF <br />`� Eleclric _Gas_Other <br />WORK DESCRIPTION <br />Iv�S�ll ol�c�-ies.s lr�a.�- �""`-� <br />N0. I TYPE OF FlXTURE OR REM <br />Balhtub <br />Lavatory (wash basln) <br />Shower <br />Kltchen sink 8 disposal <br />Dlshwashar <br />Clolhes wash or <br />Walor haaler <br />Slnk (servlce/bar/mop/elc.) <br />Backllow preventer <br />Urinal <br />OrinNing Fountaln <br />Floor draln <br />Grease trap <br />Root dralns <br />Olhar <br />m i��� <br />�+25�S�1��6h <br />PRICE OF WOflK <br />�.Da <br />NO. I TYPE OF Fl7CTURE OR ITEM17 <br />A/C — air handling t <br />Forced alr systems <br />Gas plpinp <br />Water healer <br />Gas Ilreplaca <br />Gasrangn <br />Clolhos dryer <br />RanAe hood <br />Exhaustfan <br />Heatpump <br />Unit heatur <br />Bo��er <br />Ralrigoralion <br />Woodstova <br />CITY OF EVERETT LOCAL SALES TA% COOE IS 3105 <br />I hereby cerlllfy Ihat I have read and examined Ihis applicallon and know the samo lo bo true and correct. Ail provlslons of laws and <br />ordlnacos goveming Ihls type of work will bo compllod wilh whetherspecl0ed horein c, noL 7hn pranling uf a permll does not presumo <br />lo giva authorlly lo vlolato or cancel tho provlslon ol any other stata or local law regulaliny conslrucllon or Ihe perlormance ol <br />conslruclion. Thal I am aulhorized hy the ovmer of Ihis praperty to perfarm Iho work lor which application Is mado and I comply wilh tho <br />Slala Conlractors Law 1827 RCW and 296.200 WAC. <br />