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SITE ADDRESS <br />�I t % <br />LEGAL� 40TN0. �,r <br />DESC. P'� ��l� <br />OWNER <br />� <br />TE NTNAME /�" <br />/ <br />i <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 V��O }�j <br />PARCEL TAl( I.D. ft <br />TRACT OR SUBDIVISION p <br />CONTACTFOR PERMIT <br />�CQ�{y�,� � 111 <br />�o�b'� 8� <br />I�� <br />PHOHE �ZS'�ZZ' �"7� 1 <br />E�NIAIL <br />wrv i nn� wn .. .... .,_.. . .._"_ <br />lA•� �-v�•�Ls 5 <br />CONTR.LICENSE# ♦ 1 p��� � 12��b 1���� ���s 5 q� 62 <br />►�a <br />USE OF BUILOING I HEAT SOURCE � CONTRACT PRICE OF WORK <br />_ Electric _ Gas _ Other <br />WORK DESCRIPTION <br />1�"^-� �'�1 X2�� � ✓��g <br />PLUMBING <br />NO. � TYPE OF FIXI'URE OR ITEM <br />Toilel <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas Tireplace <br />Gas range <br />Clathes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeralion <br />Woodstove <br />CIN OF EVERETT LOCAL SALES TAJC CODE IS 3105 <br />I hereby cerili(y thal I have read and examined this application and know lhe same to be true and correcL All provisions of laws and <br />ordinaces goveming lhis lype oi work will be complied with whether specified herein or not. The granting o( a permit does not presume <br />to give aulhority to violate or cancel lhe provision oi any olher state or local law regulating wnstruction or fhe perlormance of <br />construction. T at I am authorized by the owner o( this property to perform the wS�rk for which application is made and I comply with the <br />State Con tors Law 18.27�CW and 29p.200 WAC. ( I <br />� <br />� �� <br />