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{ <br />ERMIT APPLICAT�UN <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 />�3 �' APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � � Z7 ,-0ai <br />SITE ADDRESS <br />LOT NO. <br />TENANTNAME <br />PARCEL TNC I.D. # <br />TRACT OR SUBUIVISION # <br />CONTACT FOR PERMIT <br />4HONE <br />y�/�G//�J�/., ��)� f�Uf I E�MAIL <br />CONTRACTOR�-IU/.✓�i��/c�%//vio/j� AD RE �G�t /i�f�'�i�i�✓ CI �l�"..� oNe1Gf-27'6 �fj0 <br />CONTR. LICENSE # ~� ���`�� <br />USE OF BUILDING <br />� ✓�G /%f��,i J <br />WORK DESCRIPTION <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />3. ,�/�wi��i> .�>„� s <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />CONTRACT PRICE OF WORK <br />�!-��vv <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC - 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 />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TNC CO�E IS 3105 <br />I hereby ceritify thal 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 wilh whelher speci(ied herein or not. The granting of a permit does not presume <br />to give aulhoriry to violate or cancel lhe provision of any olher state or local law regulating conslruction or lhe pedormanco ot <br />construction. Thal I am aulhorized by lhe owner of lhis propeRy to perform lhe work for which application is made and I comply wilh the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />� � �7 z _UGo <br />I. / %%I:n,.�G.� � '�1 � G <br />