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S� <br />PERIVIIl' .�►PPL�CATlON <br />Cf?Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREfT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www-everettwa.org <br />APPLICATIONS ARE ACCEP'TED FROM 8 AM TO 4 PM <br />LOT NO. I BLOCK <br />� � <br />CONTR{1CTORG�r�l1 ��"r <br />N�/ <br />CONTRLICENSEt / O n <br />l0 � <br />USE Of BUILDING <br />PARCEL TAX I.D. # <br />FOR I'EitMlfT <br />noor�ss ( �pE, <br />HEAT <br />_ Eledric w Gas _ Olher <br />WORK DESCRIPTION <br />Gv�wP�� dtJb� ���' <br />PLUMBING <br />NO. TYPE OF FUCTUftE OR ITEM � <br />� Toilet <br />—`� Balhtub <br />� Lavatory (vrash basin) <br />sink & disposal <br />Clothes washer <br />Laundry iray <br />� Sink (servim./badi <br />Backflow prevep4 <br />�Unnal � <br />Drinking Fountain <br />(z Floordrain <br />— Grease Vap <br />Roet dains <br />+ Olher <br />) <br /># <br />/2 - <br />�� �$.�-2'� <br />PHONE <br />,7' dr1J' d��� 1 <br />��P"� • 2°8��75 <br />CONTRACT PRICE OF WORK <br />S—D V � C./��./ <br />u�� T��1nnJ i � M,P2r�U�µfr.J y� <br />7YPE OF FI7(TURE OR ITEM <br />AIC — air haridling units <br />Forced air systems <br />Gas piping <br />Waterheater � <br />Gas firepiace <br />LSas range <br />Cl�ipes dryer <br />Heal pump � <br />Unit heater <br />Boiler <br />Refngeration <br />CiTY bF EVERETT LOClLL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have 2ad and examined lhis application and know the same to be tnie and correct. All provisions of lavrs and <br />ordinaces goveming lhis type of work wlll be complied with whelher specified herein or not. The grariang of a permit dces not presume <br />to give authority to violate or cancel the provision of any olher state or lopl law regulating construdion or the performance of <br />construction. Th am aulhorized by the owner of this property to perform lhe work for which application is made and I compiy wilh the <br />State C c 7817 RCW and 296200 WAC. <br />�"" �_ l�-%i-D� <br />N��-rG�'_ Dn2.G-1 <br />