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PERMIT APPLICATION <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 F,RE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />LOT NO. I BLOCK <br />TENANTNAME <br />CONTR. LICENSE # <br />USE OF BUILDING <br />������� ����� Ct� <br />WORK DESCRIPTION <br />yx� <br />�t1,1_. <br />PARCEL TAX I.D. # <br />TRACT <br />ADDRESS <br />J� <br />CONTACT fOR PERMIT <br />�- D���-/S r� <br />ADDRESS <br />HEAT SOURCE <br />� Elec!ric _ Gas _ Other <br />�2 —a.-I <br />PERMIT # <br />SDlyl2-�� <br />PHONE <br />ya5 �-�; <br />CITY2IP PHONE <br />Y� <br />I CONTRACTPR <br />�SJ�� <br />; G) <br />OF WORK <br />�Jo.vc-' ✓�y 0 u,' <br />. � 9 ,� -- � ��Fpa� a ,� �,7� (�'/p, $ _ .. <br />.� , ' .A , �, <br />yYG_� i l r' �%o %r- ,`i ��' :��..I 1 E-' ;� r'=i�,i �4: <br />NG <br />N0. � TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />W ater healer <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinkinc� Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />f:ba <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Waler healer <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify ihat I have read and examined this application and know the same to be true and correcL All pwvisions of laws and <br />ordinaces goveming lhis type of work will be complied with whether specified herein or not. The granting of a permil does not presume <br />lo give aulhority lo violal» or cancel lhe provision of any other state or local law regulating construction or the per(ormance ot <br />construction. That I am authorized by ihe owner of lhis property to perform Ihe work (or which application is made and I comply with the <br />Stale Canlractors Law 18.27 RCW an¢-Q96200 WAC. ,, _ , , , <br />r <br />l <br />yz <br />