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P'�RMIT APPLICATI(�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — �v�vw.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />ARTISAN IiOMES <br />TENANTNAME <br />CONTRACTOR <br />8124 81:VI:RI.Y I.ANI: <br />BLOCN <br />ROI3INSON PLUMUING WC. <br />CONTR.LICENSE# RO-[31-NP-'?72C2 <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />TRACT <br />CONTACTFORPERMIT <br />PHONE <br />ItIiNROI3INSON-GLMSLIB (3ci0)403-74G2 <br />AD�RESS CITY2IP PHONE <br />29330 124'fll AVf? N.I:. ARLINGfON 98223 (360)�103-74G? <br />I I`�G� ril � dIF�99➢Fii`�IY�EI F�'�YA��I�i�I�i�L.Y9:� <br />NO. I TYPE OF FIXTUHE OR ITEM <br />Tailet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 dispoaal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />HEATSOURCE <br />Electric Gas Other <br />CONTRACT PRICE OF WORK <br />S?750 <br />N0. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />srRIVK�.Pit III�Aus <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritity th�t I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ortlinaces governing this type of work will be compfied wilh 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 performanco of <br />constr�ction. 7hat 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 Lawa8.27 RC'��nd 296.200 WAC. <br />� �� <br />