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SITE ADDRESS <br />n�� 7 Sc `C �� <br />LEGAL LOT NO. <br />DESC. <br />P�RMIT APPLICATI(�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREif, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TRACT <br />PARCEL TAX I.D. # <br />PERMIT # <br />�Go�a� . C� 10 <br />CITYIZIP PHONE <br />__ � �>dF��f <br />TENANTNAME � CONTACTFORPERMIT PHONE <br />CONTRACTOR ���. <br />�C �� �`'�/ �� <br />CONTR. LICENSE # �.�-,,�L � l= <br />USE OF BUILDING <br />WORK DESCRIPTION � <br />\� �C� <br />�:C:t q �Y�'�k=, <br />ADDRESS 20 � Z ��C'S � <br />HEATSOURCE <br />Eleclric Gas Olher <br />�,`��'�2.�'"` `« <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavatory (wash basin) ' <br />Shower • • <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Waler heater <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />Cv,:: <br />yZs � � �- ���y <br />CITY2IP ��- PHONE2s��(�Tf <br />CONTRACT PR�CE OF WORK <br />� " � <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C—airhandling units <br />Forced air syslems <br />'Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Cbthes dryer <br />Range hood <br />Exhaustfan <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 ceritify Ilial I have read and examined lhis application and know lhe same lo be lrue and correct. All provisions of laws and <br />ordinaces governing this lype of work will be complied wilh whether specified herein or nol. The granling of a permit does not presume <br />lo give aulhoriry to violale or cancel lhe provision of any olher slate or local law regulaling construction or lhe pedormance of <br />construclion. That I am authorized by lhe owner of this property to perform the work for which application is made and I comply wilh lhe <br />State Contraclors Law 18.27 RCW and 296.200 WAC. <br />