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PL�MIT APPLICATIG�J <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98: 01 <br />425-257-8810 — FAX 425-257-8857 — www.even+ttwa.org <br />APPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM - DEBIT & CREDIT �ARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />�� v, <br />LEGA LOTNO. <br />DESC. <br />OWNER <br />I7YPYU lC�GJNhc <br />TENANT NA��E <br />J �� i��� <br />CONTRA-y���4 CTO <br />li�cl�yl� TClvrJ �T%mG L(. G <br />CONTR. ICENSE # <br />t� -�--� a s- <br />USE OF BUILDI G <br />WORK DESCRI TION <br />1 l.D.�n.l � r. L, <br />PARCEL TAX I.D. # <br />%� Cb �.S <br />BLOCK TRACT <br />ADDRESS <br />I��` <br />CONTACT FOR PERMIT <br />�e-�`-�` o <br />ADDRESS <br />SS 4�I�{ `f� NES�;�elol <br />I — HEATSOURCE <br />Electric C ; Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />PERMIT # <br />cc�s o <br />PHONE <br />�f� �sy - 3a� � <br />CITY2IP PHONE <br />,�kes+eurns �1zs - 7�v ;� <br />I CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas ranye <br />Cbthes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Bailer <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />1 hereby cerilify that t 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 �ti�ork will be complied with whelher specified herein or not. The granting of a permil does not presume <br />to give authority lo violate or cancel lhe provision of any olher state or local law regulatir,g cunstruction or the per(ormance of <br />consWcuon. Thai 1 am aulhorized by the owner o( this property to perform the work (or which application is made and I comply wilh the <br />State Contractors 4�1827 RCW and 299.200 WAC. <br />