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SITE ADDRESS <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERETT. WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />BLOCK I 7ACTOR SUBDMSION # <br />/ -::-10-01� <br />1/L <br />U r t1G Kec a C 61 r uG �IJt'/'i_d i,�dG3 w <br />` `,. PHONE <br />TENANT NAME I CONTACT FOR PERMIT <br />-'1q%UTS2TTl .I+-'+ O� �`"+'�'nCx._ F.AII„ 1 <br />CONTR. LICENSE <br />UDt UIF BUILDING <br />WORK DESCRIPTION <br />5louc 9 <br />l-.CV1- (1 Af kv <br />HEATSOURCE <br />— Electric ZGas _ Other <br />01 PWl %1. <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ louel <br />Dalhlllb <br />Lavatory (wash basin) <br />Show", <br />Kill= sink 8 disposal <br />_ Dishwasher <br />Clothes washer <br />_ %Vale, hest", <br />_ Sink (serncefiar/mopletc ) <br />_ Back Cow preventer <br />Urinal <br />_ Drinking Fountain <br />_ Floor drain <br />Grease trap <br />_ Roof drams <br />Other <br />fill-& A <br />Swh,rnt�h �(ac.r5(n3— <br />�i8�o 4f�19 <br />CONTRACT PRICE OF WORK <br />NO. I TYPE (IF FIXTURE OR ITEM <br />-_ NG - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range flood <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 certify that I have read and examined this application and know the same lobe true and correct All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or not. The granting of a pemmt does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this properly to perform the work for which application is made and I Comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />