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SITE ADDRESS <br />D[SC. <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY UF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wv,�w.everettwa.org / b' a� ��v <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/�/a.E"C SGOT/ <br />CONTR. LICENSE N <br />USE OF BUILDING <br />PARCEI TAX I.D. # <br />cny��o�37�ovoo <br />TRACT OR SUBDIVISION # <br />FOR PERMIT <br />� /D/D-l�3 <br />�/D/� 04/ <br />velvn< �2 0{ /'/../,Y <br />n.�cc �Y3 <br />PHONE 3C 0- 9;T7' �tF�S' <br />73Z Co/6� Ave Evtr�%//9SZo/ <br />I HEATSOURCE <br />�Electric _ Gas _ Other <br />WORK DESCRIPTION <br />tZ4 'X "'-30 � GAQ.�CE <br />NO. I TYPE OF FIXTURE OR ITEM <br />Todet <br />Eialhtub <br />Lavatory (wash basin) <br />Shower <br />Krtchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Waten c�ater <br />Sink (service/barlmop/etc.) <br />6ackflow preventer <br />Unnal <br />Drinking Fountain <br />� Floor drain <br />Grease trap <br />Roof drains <br />Other <br />3�D- 9�7-3��`i <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Gxhaust fan <br />Heal pump <br />Unit healer <br />I3oilcr <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerlify Ihal � have read and examined this application and know Ihe same lo be lrue and c.orrect. All pwvisions of laws and <br />ordinances geveming this lype of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authonty to violate or cancel Ihe provision of any olher stale or local law regulating construclion or Ihe performance of <br />construclion. That I am aulhorized by Ihe owner of �his property to perform Ihe work for which application is made and I comply with the <br />Slate Conlractors Law 1827 RCW and 296 200 WAC. <br />`1 v <br />