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PE��ZMiT APPLIC�4T10�� <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADORESS PARCEL TAX I.D. # PERMIT � � <br />v�� /�1 �i �i,✓-�rna„� �.i... `.J.F'/hS.��iv.�..1.,-,� i: l �(:���CiC)S <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />Ev �'rQ+r i <br />TENANTNAME <br />.rr ! <br />TRACT <br />CONTACTFOR <br />CONTRACTOR ADORESS <br />C P� PlGmh,'N��- Nea F�'N� <br />CONiR. LICEI�SE # <br />C Pz P� �+ a��'� �� 1� 1�aa <br />USE OF BUILDING <br />Ifl1 C <br />HEATSOURCE <br />Clectric Gas Other <br />cirrrziP <br />WORKDESCRIPTION /iIl.�/✓1%iAJ����fj���N PI��'ti�F'X��(��'S <br />j'� � <br />NO. I 7YPE OF FIXTURE OR ITEM <br />Toilet <br />BaGuub <br />Lavatory (wash basin) <br />Sho�•er <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain - <br />Grease trap <br />Roo( drains <br />Other <br />PRICE OF <br />N0, I hPE OF FIXTURE OR ITEM <br />NC - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />NJoodstove <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know tna same to be true and correct. All provisions of laws and <br />ordinaces goveming this type of work �.vill he wmplied v:'ch whether specified herein or not. The granting of a permit does not presume <br />to giva authonry to violate or cancel the provision of any olher state cr local law regulaling construction or the performance of <br />construction. That I am authori<-ed by the o�vner of this praperty to perform the tivork for which application is made and I comply ��vith lhe <br />State Conlractors Law 18.27 RCW and 296,200 WAC. <br />' �. �,�' �1-'-/G ' <br />