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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 -o77 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.Org GHQ <br />Q10 a <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />Li1QUTjO� <br />PERMIT # <br />(/ <br />_-LEGALJ LOT NO. I <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. <br />OWNER <br />ADDRESS CITYIZIP <br />PHONE <br />L 7 L'tt wim i( v4y <br />rf}Cl nr; > <br />�i <br />i I . I c -P �IINwc�C� <br />i. s 7L(1 <br />TENANT NAME <br />PHONE <br />CONTACT FOR1OR <br />c1,)S --741 -jS3S <br />I <br />_PERMIT <br />E-MAIL <br />1��L`{7l��C-.CfzO /<I <br />CONTRACTOR �_ I t IL� <br />CONTR. LICENSE # f� F CA O O O D <br />USE OF BUILDING <br />UUKt55 <br />���-� Colby r4✓� <br />HEAT SOURCE <br />4 Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION J �x /� OVA — S'4e <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water healer <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 />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace Jj <br />Gas rang^ I /j <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Bjiler <br />Refrigeration <br />Woodstove <br />OUier <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 aiva <br />I hereby cerilify that I have read and examined this application and know the same to be true and correct. 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 doe, not presume <br />to give authority to violate or cancel the provision of any other slate or local law regulating construction or the performanca of <br />construction. That I am authorized by the weer of this property to perform the work fcr which application is made and i Comply with the <br />Stale Contractors L�w�8.7 F Wand 6.200 WAC. '7— 7 <br />