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SITE ADDRESS <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />' rU -ec <br />TENANTNAME <br />,�1� �( j ! (G � <br />' NTRACT R '/ ��./S <br />�`l i <br />CONTR. LICENSE #\', �/ <br />� ]�..� /. <br />USE OF BUILDING <br />� <br />WORK DESCRIPTION <br />0 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25%-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />BLOCK / I TRACT OR SUBDIVISION # <br />7 Sli ? 13'� I�. <br />CONTACT FOR PERMIT <br />S, l �-- � p <br />Np, I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Ba�htub <br />Lava�ory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler healer <br />Sink (service/bar/mop/etc.) <br />BackOow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />1i i/ - <br />HEAT SOURCE <br />_ Electric _ Gas _ Other <br />� <br />PERMIT # <br />►'�'►► p c� �►-oz 3 <br />L �,c�-- i F3l LL <br />PHONE ��J � 7 J UCrS J <br />' 2�.��inur rnvn..��� �S� <br />r.�vl ��'�� �SSS <br />� a � � � <br />CONTRACT PRICE OF WORI< <br />� <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />AIC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heal pump <br />Unit healer <br />Boiler <br />Refrigeralion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know ihe same to be true and correcf. All provisions of laws and <br />ordinances governing this lype of work will be complied with whether specifed herein or not. The granting of a permit does not presume <br />to give authorily lo violate or cancel the provision of any other state or local law regulating construction or the per(ormance of <br />construction. That I am authorized by the owner of this property ro pedorm lhe work for which app�ication is made and I comply with the <br />State Contractors Law 1827 RCW and 296.200 WAC. <br />, - �, ., �r � l �( �c� <br />