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, <br />PERMIT APPL�CATI <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />�~� .: <br />�u,',� <br />LEGA LOT NO. <br />DESC. <br />OWNE�-�[.. <br />TENANT NAME <br />�)��L•(� PARCEL TAX I.D. # <br />t .' !=• <br />BLOCK TRACT <br />ADDRESS <br />�� • �� `�( Fs6 <br />CONTACT FOR PERMIT <br />��c.�.% �ri/-}+�LS <br />CONTRACTOR +�jY���'� (��y'�pl, (� ADDRESS f <br />CONTR. LICENSE # �!)�J/�GC�fC�( P(/, <br />USE OF BUILDING <br />HEATSOURCE <br />Electric _ Gas _ Other <br />PERMIT # <br />fl <br />PHONE <br />�o—�O—?C�`C £� <br />$�+�PHONE Lo3-k7V-99 3 <br />CONTRACT PRICE OF WORK <br />�_�7S_�o <br />WORK DESCRIPTION <br />'fi�=��..i%r'M�S \ Or�— (l..» C—�L�� ��J �`�+� �l� ��J� � `� �.� <br />� <br />N0. I 7YPE OF FIXTURE OR ITEM <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <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 />.ck.-, �s � r� <br />NO. � 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 EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I here6y ceritify that I have read and examined this application and know the same to be true and corcect. All provisions of Iaws ancl <br />ordinaces governing this type of work will be complied with whelher specified herein or not. The granting of a permit does not presume <br />!o give authority to violate or cancel the provision of any other st2te or local law regulating constructlon or the performance of <br />construction. That I am aulhorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Co9tneto w 18.27 RCW aylii 296.200 WAC. <br />