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SITE ADDRE55 <br />3osN Be.l <br />L.FGAL LOT 1 <br />PERMIT APPLICATION <br />CITY OF EVERETT P�RMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8870 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FRGM 8 AM TO 4 PM <br />BLOCK <br />PARCEL TAl( I.D. N <br />ll G%%�� � / 7 <br />fENANT NAME��+� I CONTACT FOR PERMIT PHONE -- <br />3n.�- >�,�,..v„-�� <<�s-�s�-�s�e <br />CONTRACTOR ADDRESS CITYILP PHONE <br />CONTR. LICENSE / <br />USE GF BUILDING <br />WORK DESCRIPTION <br />N��. I TYPE OF FIXTURE OR ITEM <br />Toitel <br />Bathtub <br />Lavatory (wash basinl <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink �servicelbarlmop/elc ) <br />UackAow prevenler <br />Unnal <br />Drinkmg Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />_ Electric� Gas _ Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />�y <br />A/C - air handling unRs <br />Forced aii systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Ezhaust fan <br />Heat pump <br />Unit heater <br />Poiler <br />Refngeretion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA% CODE 19 �105 <br />I hereby centdy that I have read and exammed this application and know the same to be true and cortecl. All provisions of laws ar.d <br />ordinaces govemmg thre type ol work will be complied wdh whether speufed herem or not. The granting ot a pertnit does nol presume <br />to give authonry to vioiate or cancel the provrsion ol any other state or local law regula6ng construdion or lha performance ot <br />construdion. Thal I am authonzeA by the owner ol �hls property to perform lhe work for which application is made end 1 comply wilh ihe <br />Stale Contractors Law 18 27 RCW�nd 296200 WAC. <br />%''� �., ���G� <br />