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PERMIT APPLICATION <br />CITY OF EVERETT PERMI� 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 />����1. �J� �b��iZli ,�'{c��� <br />LEGA LOTNO. BLOCK <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION q <br /># <br />�IICSf.I` I"�I7,1t '�(J.� <br />TENANT �AME CONTACT FOR PERMIT PHONE <br />��IG-,',.;� C ki�uy �uVi 1. U0.,\`j E�MAIL <br />�bATRA�ibF�. _ �56TiE� TYRi <br />�_�I �V ��C: ����1� �.iIC� �Cf i• •� 1: u ��('i �� (��C i�["C ��C�w�G: l�tli� `�� J li"/ '��� / J <br />CONTR. LICENSE p . <br />�I� �I f�F= NC'1P��/ !� <br />USE OF BUILDING <br />WORK DESCRIPTION <br />HEA7SOURCE <br />�� Electric � Gas _ Other <br />�i��,�,.,�1 ; ) �L-C�=-I:�;, -�.1L11f;� L�es:� ��.,`�1�, <br />I .. I <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />W ater heater <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 />1 � ; /1 <br />j �j�; <br />' 1'/�`� �L, � <br />� <br />��� <br />NO. <br />CONTRACT PRICE OF'NORK <br />I�,t��•OD <br />NPE OF FI7CTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Range hood <br />Exhausttan <br />Heat pump <br />Unit hcater <br />aon�� <br />Refrigeratiun <br />Woodstove <br />CITY OF EVERETT LOCAL SAIES TA% CODE IS 3105 <br />I hereby ceritify �hat I have read and examined ihis application and know the same to be irue and correct. All provisions of laws and <br />ordinaces goveming this type of work witl be complied with whether specified herein or noL 7he granting ot a permit doe s nol presume <br />to give authorily to violate or cancel the provision of any other state or local law regulating construction or the pedorman;e of <br />construclion. That I am authorized by ihe owner of ihis property lo peAorm ihe work for which applica�ion is made and I a�ply with the <br />Slate Contractors Law 18.27 FlCW and 296.200 WAC. <br />