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SITE ADDRESS � <br />L G� 0 LOT NO. <br />DESC. <br />TENAN7 NAME <br />PERMIT APPLICATION <br />CITY OF E�'ERETT 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 <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION i! <br />CONTACT FGR PERMIT <br />PHOt1E <br />� E-MAIL <br />CONTRACT R ADORESS CITY2IP P N <br />CONTR. LICENSE # �G�JN�I <br />s �lb -o� <br />tMiT <br />D �� � -CO� <br />E <br />iT�? __ i�-� <br />USE OF BUILDING NEAT SOURCE CONTRACT PRICE OF WORK <br />S 0�<-- Eleclric Gas Other <br />YJORK DESCRIPTION <br />� �au „��� <br />1��,��.,�-�. (� �-e_ , t e,c a � l �� ,�� � � s� ^- � � <br />,•,i �i,r� <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />�- Dishwasher <br />Clothes washer <br />Waler healer <br />� Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roo( drains <br />_ Other <br />NO. I TYPE OF F�XTURE OR ITEM <br />A/C - air handling units <br />Forced air syslem� <br />Gas piping <br />Water heater <br />Gas firep�ace <br />Gas range <br />Cbtnes dryer <br />Range hood <br />Exhaust fan <br />Heat pamp <br />Unit healer <br />Boiler <br />RefrigeraGon <br />Woodslove <br />Other <br />CITY OF EVER[TT LOCAL SALE`� TAX CODE IS 9705 <br />i hereby cerili(y lhat I have read and r,amined lhis application and know the same lo be true and correcl. Ail pm���sions o( laws and <br />ordinaces goveming lhis rype of worF •���� he complied wilh whelher specified herein or nol. The granting o( a fermil does nnt presunie <br />to give authoriry lo violale or cancel Ihe provision of any olher slale or local law regulating conslruction or lhe pertormance o( <br />construclion. Thal I am aulhorized by Ihe owner of lhis property to perform the work for wh'�ch application is made and I comply with the <br />Slate Contractors Law 18.27 RCW and 29Fi200 WAC. � <br />S-�� -o� <br />