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PLr2MiT APPLI�ATIG�+I <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — ww�,v.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEDIT & CREDIT <br />SITE ADDRESS <br />%% i^1 . . <br />LOi N0. <br />� � � �� � ,-� <br />TENA����RAME <br />CONiRACTOR <br />'� / i <br />_ ,_ <br />BLOCK I TRACy <br />� <br />-„ � ., - <br />CONTR. LICENSE p y <br />',� <br />USE OF BUILDING <br />l / <br />-- '' � <br />WORK DESCRIPTION <br />J <br />i� , . <br />N�• I NPE OF FIXTURE OR ITEM <br />y_ Toilcl <br />=�' BalhWb <br />_= Lavatory (wash basin) <br />Shower <br />_ Kitchen sink S disposal <br />� Dish�,vasher <br />Cb(hes washcr <br />Laundry tray <br />Sink (serviceibddmop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasetrap <br />Roof drains <br />Other <br />PARCEL TAX I.D. p <br />�C!�. RG; <br />��� <br />-'� 7� r%n �� '1 <br />ICON7ACT FOR pERM1T I <br />ADDRESS <br />� <br />n/,,_, �i6 . �(c/ <br />° NOT ACCEPTED <br />PERMIT # <br />? �o S'ub `S�i <br />0 <br />�i C�..0 � � �i ^. ��%i= <br />��f�JCr)S ; 1( PHONE `'•1/.�;,,. <br />ritAl SOURGE <br />_ Fleclric � Gas ___ Olher <br />��' � �, .7`' - � <br />� , �- <br />CITY2IP PHONE <br />I CONTRACT PRICE OF WORK <br />i, <br />�=�'� � � � � �� <br />NO. I TYPE OF FIXTURE OR ITEM <br />/vc: - air handling units <br />� Forced air syslems <br />�� Gas piping <br />�, Waterhaater <br />� Gas fireplacu <br />� Gas rang� <br />� Clothos dryer <br />� Rann.hood <br />_`L Exhaust fan <br />_ Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />_ Waodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify !hal I have read and examined Ihis applicalion and know the same lo be lrue and correct. All provisions of laws and <br />ordinaces governiny this type of work will be coinplied wi(h whether specified herein or not. The granling o( a permit doos not presume <br />to give aulhoriry to violate or cancel the prooision o( any other stata or Iocai law regulaling construction or the performance of <br />con,truction. That I am authorized by !ho ovmer of lhis property to peiiorm the work for which application is made and I comply with the <br />Stale Conlractcrs Law 1827 R�W and 94F �nn wnr � , <br />7' / � <br />