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SITE ADDRESS <br />LOT NO. <br />TENANTNAME <br />PeRMIT APPLICATION <br />CtTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — w�n�w.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� �T� r� PARCEL TAX I.D. # <br />Il/�4G - <br />BLOCK TRACT <br />ADDRESS <br />s �'c� sE �/��« �,�s-( <br />I CONTACT FOR PERMIT <br />5�) 35s -�'S�ro <br />PHONE <br />�-�,�.._n,a �/ ,R�,v��srrn I K�,� �c� (4zs� zsz-B�iy- — <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />E��er3�z�.S��vr Hc�� �/�/�' tizo l��r{« cvr,- �or Cs�l zsz-3>>� <br />CONTR. LICENSE # �UE26'SS D Z2p'� <br />USE OF BUILDING <br />HEAT SOURCE <br />_ [ler,tric Gas Olher <br />PRICE OF WORK <br />WORK DESCRIPTION �('}rL( �� �fJ�F <br />�.�iu� �� Ex�sr�,v� ,�a�r- T� Gr,�� f a.�ti�� � � , � <br />A�/ ��u�7- i,v ��rn� �.�cc <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilat <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposai <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop(etc.) <br />Back(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />� A/C — air handling units <br />Forced air syslems <br />� Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />2 Exhausl fan <br />Heat pump <br />Unit heater <br />Bailer <br />Retrigeralion <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify lhat I have read an� examined this application and know the same to be lrue and correct. A�I provisions of laws and <br />ordinaces governing this lype of work will be complied wilh whelher specified herein or not. The granting of a permil does not presume <br />to give aulhoriry lo violate or cancet the provision of any olher state or local law regulating conslruction or the performance o( <br />consiruction. That I am authorized by the owner of this properly to perform the work for which application is made and I comply with the <br />State Cpnlractors Law 18.27 RG14land 2�J�.200 WAC. <br />