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PE.tMIT APPLICATIO�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org j�� �� <br />APPLICATIONS ARE ACCEPTED FROM fi AM "f0 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />NA I'X�PrKT��'�G1M'rr`nj'�R�i�P��i�'sr���%SZS�'/_"2y�`����l3�s'MFX�c��L�`�w'�•95�� <br />TENANTNAME �� <br />SN��'i•��r � P <br />CONTRACTOR <br />CONTR. LICENSE p <br />����� zZ,L J� CCNTACT FOR PERMIT <br />%i✓�y�� .d:� -- <br />USE OF BUILDING <br />�Id2 N13ri'�.a��ui�y.�D iyih�T�r <br />WORK DESCRIPTION <br />� � <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Clolhes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />PMONE <br />y1s' 3 s'3 �1i � i <br />ADDRESS CITY2IP PHONE <br />1 crls� 1���[yDh'�,�,, plo� i,vfXt'r �jZ,� 3 S3 �� <br />HEATSOURC[ <br />_ Electric _ Gas _ Other <br />NO. <br />CO�RACT PRfCE OF WORK <br />�DOo , o � <br />aoo�� <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Waler heater ��� <br />Gas Tireplaco -���� � <br />Gasrange -/ �y <br />Clothes dryer �( � <br />Range hood ///��� <br />[xhaustfan �� -�-x� / -��� <br />Heat pump / <br />Unit heater <br />Boiler <br />Refrigeration <br />V✓oodstove <br />CITY OF EVEREIT LOCAL SALES 7AX CODE IS 3705 <br />I hereby cerifiy lhat I havo read and examined this appli:ation and know the same to be true and correcL All provisions of laws and <br />ordinaces governing this type of work will be complied with whelher speci(ied herein or not. The granting of a permit does not presume <br />lo give authonty lo violate or cancel the provision o( any other state or local law regulating consWciion or the performance of <br />consWcti . That I am authorized by lhe owner of this property to periorm the work for which application is made and I comply with the <br />State_Con�actors Layt 18.27 RCW apd �96.�0 WAC. _ <br />` � L� �.i '�, ) `f'.,� � _ > ( 7•�'� , O � � -s`'' �'� <br />y�.. <br />