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PL�IMIT APPLICATIO�J <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 ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />S�T�z�ss ����.I A�� <br />LEGAL LOT NO. BLOCK <br />DESC. bb <br />OWNER <br />�' RyoN l�� N i NoS <br />TENANTNAME <br />CONTRACTOR <br />CONTR. LICENSE # <br />USE OF BUILDING I <br />G��A6� <br />WORK DESCRIPTION <br />N0. I 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 />Laundry trey <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />PARCEL TAX I.D. if <br />5937 �0 8 � <br />TRACT <br />S��AI L,�/I� <br />�`CZZ 3s��'Aye ,U�E <br />CONTAC7FORPERMIT <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />> O L <br />�� D�g <br />GTY21P <br />AR1�9� <br />CE// � <br />Cd/ # � <br />CITY2IP <br />� <br />D-oZ-N 7sf� <br />3(00 •�135'• <br />ZP�6NZZ9-3b/ <br />'��- 3 z �- z69 <br />PHONE <br />CONTRACT PRICE OP WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A1C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boilar <br />Refrigeration <br />Woadstova <br />Other <br />CITY OF E4ERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby ceritify that I have read and examined lhis applicadon and know the same to be true and corred. All provisions of laws and <br />ordinaces governing this rype of work will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating consVuction or the pertortnance of <br />construction. That I am authorized by the owner of this property to perform the work forwhich application is made and 1 comply with the <br />State Contractors Law 18.27 RCW and 296.2 0 WAC. <br />- •/� n� <br />VK,.w.,.. A"5��� n In__It_efL� <br />