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�� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVIC�S <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIQNS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRE S r. <br />I< 1� ;L �'^ L/i f nA c�f/JYI <br />LEGA LOTNO. BLUCK <br />DESC. <br />OWNER <br />/�� -✓�� X �'i� r S _ <br />TENANTNAME <br />%l��'I G',.,�� . /� ��/ <br />PARCEL TAX I.D. # <br />SUB�IVISION N <br />PERMIT # 7 <br />�0/ / <br />CITY2IP PHONE <br />/ �� � O� <br />CGNTACT FOR PERMIT <br />� � r <br />�� v�:v a.r�i5 <br />CONTR. LICENSE if ���1 l{ � I � C n C) <br />USE OF B,ULILDING 1 <br />��i/�"e��1..-v�l � <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dish�vasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/eta) <br />Backtlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasetrep <br />Roo� drains <br />Other <br />� � <br />'�%- <br />HEAT S <br />PHONE /�, �-I'- <br />v �'� �J� �- % J <br />) l l� f.� i 1 1!'� i'7 <br />Eleciric _ Gas _ Other <br />�ONTRACT PRICE OF WORK <br />/ <br />fj', O 9� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Farced air systems <br />Gas piping <br />Wa�er heater <br />Gas fimplace <br />Gasrangc <br />Clothes dryer <br />Range hood <br />Exha�stfan <br />Hea, pump <br />Unit healer <br />Boiler <br />� Re(rigeration <br />Woodstove <br />CIN OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify ihat I have read and examined this application and kno�v ihe same lo be true and correcL 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 no� presume <br />to give authority to viola�e or cancel the provision of any other state or local law regulating constmction or the per(ormance of <br />construclion. That I am au�horized by the owner of Ihis property to peAorm the work for which application is made and I compiy with !ne <br />State Cont ctors Law 18.27 RCW and 296200 WAC. <br />/l/�°- �--'_ � -%�-� '7 <br />,y <br />