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P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE', EVErZETT, WA 98201 <br />425-257-8810 - FAX 42E-257-8857 - www.everettwa.arg <br />APPLICATIONS AF E ACCEPTED FROM 8 AM T0 4 PM <br />SITE ADDRESS <br />F.LOCK i TRACT <br />DESC. <br />PARCEL TAX I.D. # <br />�L�7'� Garor.✓7"n� .�c�. �S //t !�j'ry=�!.��� <br />TENANT NAME � CONTACT FOR PERMIT <br />CONTRACTOR <br />USE OF BUILDING <br />DESC <br />ADDRESS CITY2IP <br />}.cc�.,,s r.ck:,�ti.�,�G <br />��� 7[l� 7��sr'`'Fl: N,E�r��J <br />I HEATSOURCE � <br />NO. TYPE OF FIXTURE OR I�i EM <br />Toilel <br />� itathtub <br />_� Lavalory (wash basin) <br />� ';hower <br />_� Kitchen sink 8 disposal <br />� Dishwashcr <br />.� Clolhr,s washcr <br />Waler healer <br />Sink (service/bavinop�elc.) <br />Backflow preventcr <br />Urinal <br />Drinkinc� FouNain <br />Floor drain <br />GfCBSC lfe(7 <br />Roo( drains <br />Other____ <br />_ Eleclric _ Gas <br />NO. <br />Other <br />G� ' �i' �� � � <br />PERMIT 0 , <br />� �r'� � — 4 <br />PHONE <br />��-a3�-ya9� <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />W aler heator <br />Gas (ireplaco <br />Gas rango <br />Cblhes dryer <br />Range hood <br />Exhaust lan <br />Heat pump <br />Unil healr-r <br />Boiler <br />Relrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby cerilily Ihat I have read and examined Ihis applicalion and know the same �o bo lrue and correcL All provisions uf laws and <br />ordinaces povoming �his type of work will be complied with whelher speci(ied herein or noL The granling ol a permil doos not presume <br />to give authoriry to violate or canr.sl the provisicn o( any other slale or local law regulatinc� conshuclion or the porlormance of <br />construction. That I am aulhorized by the nwner ol this propedy lo perTorm the work for v�hich application is made and I comply with the <br />Sla!e Conlraclors Law 18,27�RCW and 29G200 WAC., <br />�Z <br />