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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257.8810 — FAX 425-257-8857 — wvAv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />p A <br />SITE ADDRESS <br />i <br />.Lu , "_xk <br />PARCEL TAX I.D. # <br />PERMITA <br />LEGA LOT <br />DESC. <br />RA ORSUBDIVISIONN <br />OWNER <br />� <br />ADDRESS CITYIZIP <br />PHONE <br />TENANTNAME <br />I CONTACT FOR PERMIT PHONE <br />�1JL:.t`.-�u<��5� Cc�Lt�tal SUV <br />CONTR. LICENSE R U <br />USE OF BUILDING <br />WORK DESCRIPTION <br />(Deal rnwpw Poe <br />HEATSOURCE <br />Electric _ Gas_, Other <br />t&,S AA_ rLLu Nato wr4-h 1 Ptv ) <br />NO. I TYPE OF FIXTURE OR ITEM <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 />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />-Ir:) e; o <br />NO. I TYPE OF FIXTURE OR ITEM <br />rov — air nanoung units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaust 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 ceritify that I have read and examined this application and know the same to be true and correct. All provisions or laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting or a permit does not presume <br />10 give authority to violate or cancel the provision of any other state or local law regulating constnrction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with I:re <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />(k <br />