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----- - PcRMIT 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 ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGAL LOTT NCO. <br />BL?O�CK <br />TRACTOR SUBDIVIS`ON # <br />DESC. �Ci <br />�7v L- V� <br />'7 / <br />rfJt'1�»( r, /� /.S Y�� �S-7 9J 4 Z <br />OWNER ADDRESS CITY/ZIP <br />/ /yam,/��}PHONh <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />E-MAIL <br />CONTRACTO,R�t ADDRESS CITYIZIV PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />_Electric _Gas _Other <br />I <br />WORK DESCRIPTION GeJU-LGS GGar-c.rfc j-L.pT°Zr <br />n7ela C-ta,�de - 1� 2� '`- <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE 0" ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />_ <br />A/C - air handling units <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />_ <br />Gas fireplace <br />Dishwasher <br />_ _ <br />Gas range <br />_ <br />Clothes washer <br />_ _ <br />Clothes dryer <br />_ <br />Water healer <br />Range hood <br />_ <br />Sink (servicelbar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow prevenler <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />_ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 310'- <br />1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether 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 stale or local law regulating construction or the performance of <br />construct' . That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate ntra tors Law 18. d .200 WAC. <br />ie/ AL 3 7 <br />S' dre of Owner ontractor/Authorized Agent Date <br />