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� <br />PERMIT APPLICATION <br />CIT�Y OF EVERETT PERM!? ;.����VICES <br />3200 GEDAR STREET, �_VER[TT, �VA 9b2U1 <br />425-257-8810 — FAX 425-257-E857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS I <br />'�n� SF ���QQ'��,^C��\��n <br />;c�c�sco PERMIT # <br />p I C�CZ <br />LOT NO. I BLOCK .:ACT OR SUBDIVISION i <br />C. <br />ADDRESS <br />�.'� �O\u���o��� �`���00 <br />TENANTNAME <br />��.SCC� � <br />CONTR�T� <br />A`�10 ��\c <br />CONTR. LICENSE 7 <br />{ <br />USE OF BUILDING <br />��� <br />�\� � �i�� <br />\' <br />PHONE <br />P"JtsoX ��3� � <br />\V \����J.�L. - \��� <br />--�D <br />���0� <br />�14�= <br />,�� c. <br />'�: �iV� <br />HEAT SOURCE I� TRACT PRICE OF WORK <br />i� Eleclric _ Gas Other �—} \ J\ I <br />WORKDESCRIPTION �����a`�� �����C���\�x\� p' <br />Cl:�. _ <br />� sC��� �� " 5.���-o�\\ �c�� S���k.� <br />N0. I TYPE OF FIXTURE CR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />� Kitchen sink & disposal <br />� Dishwasher <br />Clothes washer <br />NJater heater <br />' Sink (service/barlmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Four�tain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />NO. <br />TYPE OF FI%TURE OR ITEM <br />A/C — air hantlling unfis <br />Forced air syst::ms <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 TAX CODE IS 3105 <br />I hereby certi(y that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances guverning this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to gi e authority to violate or cancel the provision of any other state or local law regulating wnstruction or the peRormance of <br />pons ruction. hat I am auth,Qrize��b1( the owner of this property to pertorm the work for which application is made and I comply with the <br />$tat ,Contrac�ors Law 18.27 RC(!�% ahd 296200 WAC. � � <br />r_o.�n <br />