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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 ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGAL LOT NO. <br />Bi7OCK7 <br />TRACTOR SUBDIVISION # <br />DESC. <br />OWNER rf- CITY/ZIP P�H�yO/�^�� <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />E-MAIL <br />CONTRACTOR 1//2ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />OS c:r v �✓� �/(J <br />V `J <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric _ Gas _ Other <br />WORK DESCRIPTION 17J! / <br />va& 32- 7 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet I I <br />A/C — air handling units <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) 11 <br />Gas piping <br />' <br />Shower 1, <br />k <br />Water heater <br />Kitchen sink & disposal <br />— <br />Gas fireplace <br />Dishwasher <br />�, <br />Gas range <br />Clothes washer1 <br />Clothes. dryer <br />Water heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />Exhaust fan i� I i <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <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 />ordinates 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 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 Contractors Law 27 RC and 296.200 WAC. <br />��— /Al lew <br />Signa ure of Owner/Contractor/Authorized Agent D to <br />