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(- <br />PERIlAIT APPLICATION <br />CITY OF EVERETT PERMlT 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 8 CREDIT CARDS ARE NOT AGCEPTED <br />SITE ADDRESS <br />I�}� <br />LEGAL LOTNO. <br />DESC. t'�� p <br />BLOCK <br />v c�zo� ,nf t eE�.� <br />TENANTNAME <br />'V-��-l'Zt7x� 1.4�1 P-��-S� <br />CONTRACTOR ���t���7 � (^ <br />"V <br />CONTR.LICENSEM ,n. . . _ �,�. ... �. <br />USE OF BUILDING <br />��r � <br />PARCEL TAX I.D. # <br />7�,0 r"J� P� (70�K <br />TRACT <br /># <br />a�� �" � la I=�r A�r� �� P�-tt�/l,t� RBLL'18 <br />ICONTACT FUR PERMIT PHONE <br />M�K-�'K--C.-i2F.l._�.'I�E�-K-I Zo(o-�$32--�IZz- <br />ADDRESSC,/�nr.' �� �.Ut LCITY/Z�P �HONE ��.'��Z3 J, <br />./�/fJ % cJ : ��; ` <br />,.� A�.�, /; / 1,,;� � �b't�� <br />HEAT <br />� Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />�'q � Uco <br />WORK DESCRIPTION <br />12�y�i�� 'Ti.UO t rt[-�C�Ef� 12-O�-FTOP I.L3� tTS W�'"rH- Ol� <br />3:5 --ro r� � or:,� c�--�DN N-�� Pu,�v� (� <br />PLUMHING <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Lacmdry tray <br />Sink (servicelbarlmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasetrep <br />Roof drains <br />Other ___ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothe� dr�er <br />Range hood <br />Exhaust (an <br />Heat pump <br />Unit healer <br />8oiler <br />Rehigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAJ( CODE IS 3105 <br />I hereby ceritify Ihat I have read and examined Ihis application ond know the same lo be lrue and correct. All provisions of Iaws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The grenting of a pertnit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulaling construction or the pedormance of <br />construction. That I am authorized by the owner of this property to perform tne work for which application is made and I comply with the <br />State Con ra ors Law 1�27 R�VJ�.�rtB2Q6.200 WAC. <br />