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SITE ADDRESS <br />LEG� LOT� <br />DESC. <br />OWNER <br />.l�' � �r <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8657 — www•everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX'.D. # <br />BLOCK I �ACT OR <br />CONTACTFOR <br />�.v�vmM�.i�n , <br />SN��1tJGd'IGN c.Au�S�nSU 1-t�3��uRGRA� <br />CONTR. LICENSE # ' <br />USE OF BUILDING <br />HEATSOURCE <br />Electric _ Gas _ Other <br />`�_I� �I <br />MR# � <br />90� no: <br />�� <br />(20b) 5�{ 2-8137 <br />CONTRACT PRICE OF WOR.0 <br />.�- <br />WORK DESCRIPTION'���L� ��I\ ��G� S�G�J �� �,�}2()N IC N1�S.�� 1�E D�S�I,A"f ��"ND <br />1 <br />qNc�) ��,���.o w�� sla�, e�������'����-�� <br />�`"/����� PLUMBING MECHANICA� <br />NO. � TYPE OF FI%TURE OR ITEId <br />Toilet <br />Bathtub <br />Lavatory fwash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Cbthes washer <br />W ater healer <br />Sink (service/barlmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinkinc� Founlain <br />Floor drain <br />Grease Irap <br />Ruof drains <br />Other <br />N0. I TNF`- OF Fl%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 />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeralion <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerili(y Ihal I have re.:d and examined this applicalion and know the same to be true and correcL All provisions of laws and <br />ordinaces goveming this type of work will be complied with whether specified heroin or not The yranting of a permit does not presume <br />to give authority to violale or cancel the provision of any other state or local law regulating conslruction or the performance of <br />consUuction. That I am aulhorized by the owner ot lhis property to perform the work tor which application is made and i comply with the <br />State Contractors Law 18.27 flCW and 296.200 WAC. <br />i/ �tl i Li — / i �' . . <br />/ <br />