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,� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EV[RETT, WA 98201 <br />425-257-8610 — FAX 425-257-8857 — wv✓w.everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRES <br />`� 2� <br />LEGAI LOT NO. ' BLOCK <br />U[SC. <br />OWNER <br />� vwl � �'t �Gr.�_ __ <br />TENANTNAME <br />�� �c. JOt�'{. N�iF��l q A� I <br />--, <br />CONTR. LICENSE M� P� r1.,,-C � I <br />ri <br />USE OF BUILDING <br />� � � � � <br />WORK tSESCRIPTION <br />(�.cPVz�.� C��`��'N.� <br />PLUMBING <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 3 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Barkflow preventer <br />Urinal <br />Drinking fountain <br />Floor drain <br />Grease Vap <br />Roof drains <br />Other <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION N <br />ADDRESS <br />�Cz�4� � /b � <br />CONTACT FOR PERMIT <br />�� l� -r� �-We <br />� 9i� �� — <br />HEATSOURCE <br />� Glectric _ Gas _ Other <br />C.�c c i r� c.� /v� a �z � <br />NO. I <br />/O-���/D <br />PERMI7 N <br />.1� l f il l) � �%C <br />' PHONE <br />G�rr�b <br />t�-�n_ni�_ _ 1'�Z5.1�,..l,zi' <br />CONTRACT PRICE OF WORK <br />� . � 5 <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Range hood <br />[xhaust (an <br />Heat pump <br />Unit heater <br />Doiler <br />Refrigeralion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3705 <br />I hereby certify Ihat I have read and examined this application and know ihe same to be Irue and correct All provisiuns of laws and <br />ordinances governinc� this type of work will be complied wifh whether specified herein or not. 1'he grenting of a permit does not presume <br />to give authonly to violate or cancel the provision of any other slate or local law regulating construction or Ihe pertormance of <br />construction. That I am authorized by the owner of this properly lo peitorm the work for which application is made and I comply with the <br />State Contract raiaw 1827 RCVJ and 296.200 WAC. ' / / <br />� � . <br />u <br />