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SITE ADDRESS <br />LOT NO. <br />DESC. <br />CONTRACTOR <br />CONTR. LICENSE B <br />USE OF BUILDING <br />PErtMIT APPLICAT90'iv <br />CITY QF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereltwa.org <br />ANPI_ICATfONS ARE ACCEPTED FROM 0 AM TO a PM <br />PARCEL'fA:( I.D. p <br />TRACT <br />CONTACT FOR PERMIT <br />AODRESS <br />HEATSOURCE <br />Eleclric Gas Other <br />WORK DESCRIPTION <br />l ��o1s� 1-��� <br />NO. I TYPE Oi� FIXTURE OR ITElA <br />Toilel <br />Bathlub <br />Lavalory (wasli basin) <br />Shower <br />Kilchon sink & disposal <br />Dishwasher <br />C�othes washer <br />� Waterheater <br />SInF jservice/barlmop/elc.) <br />Bar.r,ll�w prevcnlor <br />Urinal <br />Drinkinp Fountain <br />Floordrai!i <br />Groaso lrap <br />Roof drains <br />_ Olhor <br />PERMIT # <br />1� 0�7 0 <br />PIiONE <br />CITY2IP PHONE <br />I CONTRACT PRICE OF WORK <br />N0. I TYPE OF FIxTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Walon c�ater <br />Gas fireplaco <br />Gas range <br />Clothos dryer <br />Range hood <br />Exhausl fan <br />Heal pump <br />Unit heator <br />Baller <br />Refrigeralion <br />Woodstove <br />Olher <br />� _ , ,. , `'�'� 11 . <br />CITY OF EVERETT LOCAL SALES TNC COUE IS 37q� �- <br />`U; <br />I hereby corilify Ihat I havo read and examined this applicalion and know lhe same to be irueVand CoqeFL �All pibv�sions ol laws and <br />ordinaces c�overning lhis typn o( work will be complied wilh whother specifiad heroin or noL ThBlgr�nli�gpf a permit does not presume <br />to givo aulhorily to violalo or cancel lho provision o( any olher state or local law regulating construttlon or lhe performance of <br />conslruction That 1 am authorized by lho owner of this propo�ly lo podorm the work for which applicallon Is made and I comply wilh lhe <br />Stato ConUactors Law 18.27 RCW and 296.200 WAC. <br />