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PERMfT APPLICATION <br />CITY OF EVERET7 PERMIT SERVICES <br />3200 CEDAft STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FRJM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />ADDRESS <br />.�l/�� I PARCEI TAX I.D. # <br />'7Z[`F�I�Lb?�C)(, <br />LOT NO. BLOCK � I TRACT <br />DESC. ��T <br />OWNER ADDRES� <br />C e�e�-% �,��i�Q., �r� � 449 � �zl�c .�k Y1Qo <br />TENANT NAME CONTACT FOR PERMIT�..^ _ <br />� �.J.� �''il m n✓'✓il I ��l'� 1� ��`-�� <br />CONTR�iI _ • �� � �� n <br />�,L l.�ed�'t <br />CONTR. LICENSE # rJ ,_., � , � � , <br />USE OF <br />WORKDESCRIPTION in'�L``1 <br />ADDRESS . <br />a i'7a ������,�..�` <br />� �� <br />HEATSOURCE <br />Electric _ Gas _ Other <br />S�f�C,, Cc.:4 �/cT� <br />, PHONE � <br />�. N�W K%(U �- WIO��M.IJSLIi '` Oi�YJwES <br />A <br />NO. I TYPE OF FIXTIIRE OR ITEM <br />Tailet <br />Balhtub <br />Lavatory (wash basin) <br />Showar <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Unnal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />a'2C/, <br />PHON�E„ ^^^^' <br />�� "V � C�L�VJ <br />aCo�� - y�5 <br />CONTRACT PRICE OF WORK <br />,i''.".� �i <br />i - <br />NO. 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 />Refngeration <br />Woadstove <br />CITY OF EVFRETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritiy that I have read and examined this application and know the same to be true and correct All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The grenting of a pertnit does not presume <br />to give autharity ro violate or cancel the provision of any othar state or local law regulating construction or the performance cf <br />con5tcuction. hat � am authorized by the owner of this property to perfortn the work for which application is made and I comply with the <br />State�Contr�c� Law 1827 RCW and 296200 WAC. ( <br />n �� 1�L121I�5� <br />