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z <br />NO. <br />� <br />� <br />PERMIT APPLf��ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CcDAR STREET, EVERETT, WA 98201 <br />425-257-8610 - FAX 425� 257-8857 - www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM A AM TO 4 PM <br />�;�ee <br />BLOCK <br />PARCEL TAX I.D. # <br />CONTACT FOR PERMIT <br />iv�� �f � <br />CONTRACTOR�vL�� iMAcv e.�1F-.�In✓r nooRess /S�;! GG �Jt�� <br />1%C•�JJ S ' <br />:ONTR. UCCNS' J �/C�J 1 M � (� `j (p I .� r , ���7 � <br />y. <br />USE OF BUILDING E T SOl'i.^•E �� <br />/� n � � �N �w i I _ Eledric _ Gas _ Other � <br />WORK DESCRiPTION �" � , <br />%NS7�'��L UNE /iaJhlp f /�u—.(' In��n..l(7 <br />.Si�m AS �%�r �'�rCc..vr15' • <br />NU. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />hckFlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />� <br />y ��--0 7 <br />PERMIT # <br />S �C3 � vo <br />PHONE <br />'c0(,. -,f2Y- <br />L i �L/ <br />PHONE <br />:IP PHONE ZjI- �S� <br />,�rNT — S'!� co <br />��4 4',Fu3"t <br />I f:ONTRACT PRICE OF WORK <br />� Q". 0 0 �� <br />/ ��vn.. , 7'/'Pc'1 f2.�c�,� <br />NO. I TYPE OF FIXTURE OR ITEM <br />aC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other �/l•� <br />CITY OF EVERETT LOCAL SA:ES TAX CO�E IS 3105 <br />I hereby ceritify that I have read and examined this application and know ihe same to be true and correcl. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specif ed herein or no!. The grenting of a permit dces not presume <br />to give authority to violate ur cancel the provision of any other state or local law regulating construction or the perfortnance of <br />construction. That I am authorized by t owner of this property to perform the work for which appliwtion is made and I comply with the <br />State C ntractors Law 1827 RCW d 96.20 WAC. � <br />. 'i� � �.� �� 7 <br />Signature o wner ontr�d /Aul onze gent D te <br />��L <br />