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PERMIT APPLICATION <br />CITY OF EVEREi'T 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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />so�� <br />LEGAL LOT NO. <br />DESC. <br />NAME <br />BLOCK <br />e � rq,� Frn �-h.�` <br />TR. LICENSE # <br />n , � � �_�K O2 0 / <br />U�/S�E'OF BUILDII <br />/Le'�ct t L <br />TAX I.D. # <br />CONTACT FOR PERMIT <br />'fi... .� . . . <br />ADDRESS <br />��S $T� -r�' <br />� 4 � <br />CITY2IP <br />�t t,%'+�LR�n ���3 <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />PERMIT # <br />2f <br />ct. <br />PHONE <br />PHONE LE2 S <br />cS'ot� 12a <br />�ONTRACT PRICE OF WORK <br />1 /�,�no•.�� <br />WORKDESCRIPTIONr,C,Qµ'1pVQ e,�15��N� �.(t{LC !,{�pU�l`�'•,_,/ S[QN � T%�>��L <br />� �c� ..�•- <br />�C �V �XTev(cx� TcGu/�� wnJL� tMC� S[ �q1� u• � L��P%S�c� <br />(2ecu+��kq �� S'�br�- 5 (`Y�1�LtA�^ �'f'� � �2C��re ��4s�,4y T-rua.�- /---4c� <br />�J <br />C'i N C�J.�_,� A.� UfJn[l f.� . <br />NO. I TYPE OF fIXTURE OR ITEM <br />Toilat <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mopJetc.) <br />Backflow preventer <br />Urinal <br />4rinking Fountain <br />Floor drain <br />Greasetrap <br />_ Roof drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC - 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 />Exhauslfan <br />Heat pump <br />Unit heater <br />— ooiler <br />Refrigeretion <br />_ Woodslove <br />_ Other �rp� <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby cerilify lhat I have read and examined this application and know the same to be lrue and wrrect. All provisions of laws and <br />ordinaces governing lhis type of work will be wmplied with whelher specified herein or not. The granling of a permit does not presume <br />to give authority to violale or cancel the provision of any other slate or local law regulating construction or lhe pedormance of <br />co9�truction. That I am authorized by the owner of this propeAy ta perform lhe work for which 2pplicalion is made and I comply with the <br />S�at� Contractors (,aw 18.27 RCW and 296.200 WAC. <br />