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PCRMIT APPLICATI(.,N � � �'� ""' � - <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 PA7 <br />SITE ADDRESS <br />`l /L' S �- E-<<.t.� n�t a.L� <br />LOT NO. � BLOCK � I TRACT <br />TENANTNAME <br />;�:= r-7��, l-� <br />CONTRACTOR d/,�r,tJ ;- <br />se a <br />i1 ��� y� .� /�% � �3" . <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PARCEL TAX I.p. # <br />PERMIT # <br />I�a5� I -CU� <br />CITY2IP PHONE <br />��� ��i C <br />L f�l�C'% r }/ Gti'(�.�E.C.� L'J�< <br />CONTACT FOR PER�11T PHONE <br />!P�v � y.�S ��.� 7i ��.� <br />ADDRESS CITY2IP PHONE <br />��l �U�C /�� /�� ��.fl,��4 ��i;0 �'� � <br />_ �`)�� JY Z JU <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />L�'� <br />_ Electric _ Gas _ Olher �����G� � ' <br />�i/l� l � % Sir<J/ `� f�.:u /�'��cc <br />j �O. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavatory (wash basin) <br />_ Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />L Sink (service/badmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />ICAL <br />N�• I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas pipinc� <br />Z Waterheater <br />Gas fireplace <br />Gas range <br />Cblhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Retrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby r.eritify lhat I have read and examined this application and know lhe same to be lrue and correct. All provisions of laws and <br />ordinaces governiny lhis type of work will be complied with whether specified herein or not The granting of a permit does not presumo <br />to give aulhority to violate or cancel Ihe provision o( any olher state or local law regulating construction or the pedormance of <br />construction. Tha61 am authorized by the owner of lhis property lo pedorm ihe work for which application is made and I comply with the <br />Slate Contracto� Law 18.27 RCW and 296.200 WAC. <br />