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SITE ADDRESS <br />LOT NO. <br />l -f- C.�- s <br />TENA TNAME <br />� <br />PERMIT APPLIGATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8610 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AiN TO 4 PM <br />PARCEL TAX I.D. # <br />BLOCK I� TRACT <br />CONTACT FOR PERMIT <br />CONTRACTOR �/V t�D �`ut„��']�'��.1 A��RESS �SSa <br />���..�� <br />CONTR. LICENSE tt �U �J� ��C;51 � .� <br />USE OF BUILUING <br />WORK DESCRIPTION <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mopletc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher . ��G.w .c c �7c ..� j <br />iMIT # <br />%�/ - /�-� `� <br />PHONE <br />IC'O CITYZP PHONE <br />way Nw; 8��+���-t ttm � ►4 `��31 <br />SZ <br />— HEAT SOURCE I CONTRACT PRICE OF WORK <br />Elechic Gas Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <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 ceritify that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br />ordinaces yoveming this type of work will be complied with whether specified herein or noL The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with lhe <br />State,COMractors Law 18.27 RCW and 296200 WAC. <br />