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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.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS St. <br />';UU SC ✓ l/Gt /� w- <br />LEGAL LOTNO. BLOCK <br />DESC. <br />O R <br />f c/�•'� S� a �c�7�✓��rt <br />TENANT �IAM� <br />� �. <br />.1�I/G ii u/ i �ii/ S <br />2i�n� �a <br />CONTR.LICENSE# i2uSSCsC Uao a <br />USE OF BUILDING <br />WORK DESCRIPTION � � S, ! <br />� <br />Ch�,�l�{/ /Yf,4,r , <br />PARCEL TAX I.D. # <br />TRACT OR SUBOIVISION 11 <br />U <br />r � v� �- /�Iti // ('t- <br />FO ERMIT <br />/ .ssP/� <br />6 -��f-ro <br />�./0��� -0�7 <br /># <br />C ��if f�- � s3 - Fsyco <br />PHONE y2 S• ��S' 7U/ u <br />EdNNLiA�I.. pVUiSi��s'eiAL <br />���� �"�c'�-�� 9�v�� <br />SOURCE <br />Electric Gas Other <br />CONTRACT PRICE OF WORK <br />// �i �w r�.� o � ..�—i%�; -,��� a/ <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub ' <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <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 I7EM <br />A/C — air hantlling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CIN OF EVERETT LOCAL SALES 7AX CODE IS 3705 <br />I hereby certi(y that I have read and examined this application and know the same to be true and corred. All provisions of laws and <br />ordinances governing this type of work will be complied with whether speciued herein or not. The �renting of a pertnit does not presume <br />to give authority lo violate or cancel the provision of any other sWte or local law regulating const��ction or the performance of <br />construction. That I am authorized by theA wmer of this property to perfortn the work for which application is made and I comply with the <br />State Cootractors Law-t9�27 RCW and29F200 WAC. . � <br />v <br />Co <br />