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SITE A�DflESS <br />LOT NO. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMI� 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 />PARCEL TAX I.D. q <br />BLOCK � TRACT OR <br />PERMIT # <br />s►�nlw��Rt u.c, 1��� ��-w��C G� rxrv��� `�az3 <br />CONTR. UCER3E li <br />USE OF BUILDING <br />HEATSOURCF: <br />_ Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />'�EY�3P� c19 a7 � 1}ND �n1s-rr�u;��� �t�"CUro �rt" C��' p�T� <br />�C�, �uc (�,�. <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <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 />N0. 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 />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler � - � � <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETf LOCAL SALES TAX CODE 19 3105 <br />I hereby ceritify Ihat I have read and examined this application and know the same to be irue and correct. All provisions of laws and <br />ordinaces governing ihis type of work wil! be complied with whether specified herein or not. The granting of a permit does not presume <br />to give au�horiry lo violale or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform Ihe work for which application is made and I comply with the <br />State Cont�ctors Lav� 18.27 RCW and 296200 WAC. <br />