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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa Dig <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />NO. I BLOCK <br />clacyll <br />TENANT NAME <br />Mow141 Sig';)/'::�' Ih& <br />CONTR. LICENSE 0 <br />PA, AV- I si - 011_1 <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />OR SUBDIVISION 0 <br />CONTACT FOR PERMIT <br />IV tvive_e n <br />-72_04�NE Ll�v`St <br />HEATSOURCE <br />Electric Gas Other <br />PHONE %4 Z'7 L4 % GJ <br />�nw,pJ� L 7Z5 Llgy '(Poo <br />�igoz� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />nfi�uo.Ll1 VV)V� s� inn 1✓ I n �sl a CeL o -F D t <br />nrJ� , <br />I, �^r,CtA-at5te_ P " -2777 <br />A' <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ Toilet <br />_ Bathtub <br />_ Lavatory (wash basin) <br />_ Shower <br />_ Kitchen sink 8 disposal <br />_ Dishwasher <br />_ Clotheswasher <br />_ Water heater <br />_ Sink (servicelbadmop/etc ) <br />_ Backflow preventer <br />_ Urinal <br />_ Drinking Fountain <br />_ Floor drain <br />_ Grease trap <br />_ Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read end examined this application and know the some to be true and coned. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authonly to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. Thai I am authorized by the owner of this property to perform Ih@ work for which application is made and I comply with the <br />Stale Contraclor"aw 18.27 RCW and 296,GO WAC. / 7 <br />