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r <br />PERMI'T APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />�2v NOr%l� �vDt <br />LEGA LOTNO. BLOCK <br />DESC. <br />OWNER <br />�c s Mun,,� �c <br />TENANTNAME <br />�GFTR�1 FiU�,'/( � — <br />N� <br />CONTR. LICENSE k <br />USE OF BUILDING <br />PARCEL TAX I.D. p <br />TRACT OR SUHOIVIS�ON �I <br />CONTACT FOR PERMIT <br />ikN <<VTFITI\J <br />NEAT SOURCE <br />_ Eiectric Gas _ Olher <br />WORK DESCRIPTION <br />,C>,�o%- ! wo-�l, �d -2 doo/�s. <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />^ Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backtlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />1l —/G � <br />PE IT p <br />��� <br />�Z5�3?z `!�!�yo <br />�'�:v7f0.'v AGMAyL .00�7 <br />CONTRACT PRICE OF WORK <br />�J✓�'d ? <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas firep�ace <br />Gas range <br />Clothes dryer <br />R2nge hood <br />Ezhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know lhe saine to be true and correct. All provisions of laws and <br />ordinances goveming this lype of work will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />to give aulhority to violate or cancel the piovision of any other state or local law regulating wnstruction or the performence ot <br />conslruction. Thal I am aulhorized by Ihe owner of ihis property lo peAorm the work for which application is made and I comply with Ihe <br />State Contractors La�Y 18.27 RCW and 296.200 WAC. <br />��Z <br />