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� � <br />=���,�a����-� �-�� ,�, <br />`��;;���c� - <br />�ITE ADDRESS <br />�.�_'.- A l0'! NO. <br />OYl1¢q <br />� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMI7 SERVICES <br />32D0 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 <br />PARCEL TAX I.D. # <br />SUBOIVISION # <br />, ,_L�.(YC `t �Z2.C;1� C�. <br />TENAfi:NpME I CONTACTFOR <br />PHONE <br />� E•MAIL <br />I <br />Sl�;v�e��c�ci �-�1,�������� �l`��1� S��lU�rr��[��-�ct��Si���e.��1�,1s��_�: <br />CONTR. LICENSE p " <br />.:�zLV j= =C �.���� . j li <br />USG OF BUILDING <br />�'L� l,l���� �� � ' � _ . <br />WORK DESCRIPTIO��' <br />S\1J�Ct��; , - • , (. '. ����� <br />' `\c�_�1C�� ,'\��1�\ahc1 '�� � <br />PLUMBINO <br />���� TYPI' �I' FIXTURE Oq �TGM <br />lollel ._. — —__ <br />Ba�h�ub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />� Water heater <br />� Sink (service/bar/mop/etc.) <br />,>>. Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />HEAT SOURCE <br />___ Eleciric _ Gas _ Olher <br />,�il c(1 _ <br />CONTRACT PRICE OF WORK <br />,�:-��\�i�.c� �,.i�C�1C,h �,v��1%�l'.Y1�7 <br />l:C t1 � U cIQ�L � U\��'�Q.1"l'�" <br />NO. I NPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas lireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust lan <br />Heat pump <br />Unit heater <br />Boiler <br />Fiefrigeration <br />Woodstove <br />CITV OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby ceritify that I have read and examined this application and know ihr, same to be ime and cormct. All provisions of laws and <br />ordinaces goveming �his type ol work will be complied with whether specified herein or not The granting ol a permit does not presume <br />to give authority Io violate or cancel the provision of any other state or local law regulating conslmction or the pedormance of <br />const,-uction. That I am authorized by ihe owner o( ihis property to pedorm the work (or which application is made and I comply with the <br />State Contractors Law 18.27 �ICW and 296.200 WAC. <br />-i 1�'� i n 1� ! Q(' �� _-���V�i,_,.� C'r . o� `- ��'i1� <br />