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'�EKMIT APPLICAiION <br />CITY OF EVERETT PERM�T SERVICES <br />3200 CEDAR STREET, EVERETl, 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 i��L� � S L' ��t! t}f�II�'(II�Yc�� PARCEL TAX I.D. # I �RMIT # <br />7ENANTWAME CONTACTFORPERMIT PHONE <br />CONTRACTOR ( �%C I� I�.i �.I ����-�L!!���V, rJ ,LAD�RESS �O �J��(�/� �q CITYIZIP PHONE � j j .- <br />17������'� �%i�'O'/� '%55 - <br />CONTR. <br />USE OF BUILDING <br />n���s-�<�r����l.� <br />WORKDESCRIPTION � _� .�IUIb1(711�r <br />� <br />� <br />NG <br />TYPE OF FIXTURE OR ITEM <br />Todet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Disi•washer <br />Cbthes washer <br />Waler healer <br />Sink (service/bar/mop'etc.) <br />Back(Iow preventer <br />Urinal <br />Diinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher�f(";-nl,'(�5�1 Slllli`> <br />HEATSOURCE <br />Eledric Gas Other <br /><� ,� <br />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 f replace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />WoaJstove <br />Other <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this application and know lhe same to be lrue and correcL All provisions of laws and <br />ordinaces governing Ihis lype of work will be complied wilh whether specified herein nr noL The granting o( a permil does not presume <br />to give aulhority lo violale or cancel lhe provision of any other state or local law regulating constmction or Ihe pedormance of <br />consiruction. Thal I am aulhorized�,by the owner of this pmperty to perform the work for which application is made and I comply wilh the <br />Slate Contractors Law 18.27 RCW�and 296.200 WAC. <br />. 1 � . � �' / ., � . ,. �l /7 _� ,l .7 <br />