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APPLICA <br />;ITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />S� MSE I �/�R� Y�IP•TSanI 4Z5-34 S—I Z�q <br />CONTRACTOR ADDRESS CITY2�P PHONE <br />_ Electric � Gas <br />Toilet <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />CONTRACT PRICE OF WORK <br />,.__ . <br />A/G — air hantlling unrts <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />i hereby ceritify that I have read and examined this application and know the same to be We and correct. AI� provisions of laws and <br />ordinaces governing this lype of work will be complied with whelher specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law reguladng construction or the pedormance of <br />construction. Tha am rized by the owner of lhis property lo perform the work for which application is made and I comply with the <br />Stale Contract� 1�RCW and 296.200 WAC. � � <br />