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LOT NO. <br />TENANTNAME <br />�i�1�� S �Q � <br />CONTRACTOR���� <br />CONTR. LICENSE # „„ <br />USE OF BUILDING <br />, <br />P�RIVIIT APPLICATIt�N <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 <br />PARCEL TAX I.D. # <br />OR SUBDIVISION # <br />CONTACT FOR PERMIT <br />C��IGI��/�'/�. <br />i' 9SC-�cx� <br />PHONE <br />PERMIT# <br />���r� <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />_� <br />Electric _ Gas _ Other �, <br />WORK DESCRIPTION <br />P��la�e Pl u m?�,vc �-(� i�x-�u r� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mup/elc.) <br />Backflow prevenler <br />Urinal <br />Drinkinc� Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Other <br />N0. <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air syslems <br />Gas pipirg <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Ranc�e hood <br />Exhauslfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES TA7C CODE IS 3105 <br />I hereby ceritify that I have read and examined lhis application and know the same lo be lrue and correct. All provisions of laws and <br />ordinaces c�oveming Ihis type ot work will be con�plied with whether speci(ied herein or not The granting o( a permil doPs not presume <br />to give aulhoriry lo violale or cancel the provision of any olher slate or local law regulating consWction or lhe performance of <br />consiruclion. Thal I am aulhorized by lhe owner of Ihis property lo perform the work for which application is made and I comply with lhe <br />Slate QonUactors Lay+ 18.27 RCW and 296.200 WAC. <br />