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P�,RfVIIT APPLICATIC.N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREl7, V�/A 98201 <br />425-257-8810 — FAX 425-257-8857 — vrww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT # <br />2 E a A ��o�i��- oa-z <br />LEGAL LOTNO. BLOCK TRA T <br />DESC. <br />TENANT NAME CONTAGT FOR PERMIT PHONE <br />W�ssaok2 �nvy Gr�s-� ;� �1 � ►-�g1�— <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />CYOI� F�Y� '��� � �pX ',2113 <br />`C��ticwSEt�I��4�lu�. YYl �\\ C,Y-e21� I,v A- q�O�Z <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />�Q �\ n `` _ Eleclric _ Gas _ Olher <br />7� '`lJ� <br />WORK DESCRIPTION <br />�. �c� S�Y'1v1�—���" �/1�S <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas range <br />Cbthes dryer <br />Range hood <br />Exhausl fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Waodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TlJC CODE IS 3105 <br />I hereby cerilify lhat I have read and examined this application and know lhe same to be true and wrrecL All provisions oF laws and <br />ordinaces governing this type ot 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 af any other stale or lacal law regulating construction or the performance of <br />conslruction. That I am authorized by the owner o( this property lo perform the work (or which application is made and I comply with the <br />State,£ontractors Law 18.2i RGW and 296.200 WAC. <br />