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SITE ADDRESS <br />LOT NO. <br />DESC. <br />P�I�MIT APPLICATION <br />CI'TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT', WA 98201 Cj � a6 _06 <br />425-257-8810 — FAX 425-257-8857 — www.everett�va.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />CLOCK I TRACT <br />PARCEL TAX I.D. # <br />i�l �0 / �.`�(� <br />D�JI'D �,.n �0�1�2i "2 <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />Cc;.�,srr�-�.� �v�[..�7�.� o � <br />CONTRACTOR P.DDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />� oi ZCz- <br />USE OF BUILDING <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bath�ub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water healer <br />Sink (service/badmop/elcJ <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher _ <br />HEATSOURCE <br />Eleclric Gas Olher <br />� <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clalhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeralion <br />Woodslave <br />C�TY OF tVERETT LOCAL SALES Tlilt CODE IS 7705 <br />1 hereby cerili(y that I have read and examined this application and know the same to be true and correcL All provisions of laws and <br />ordinaces governing this rype o( work will be complied wilh whe:�er specified herein or not. The granting cf a permit does not presume <br />to give authority to violate or cancel the provision o( any olher staa� or local law reguiatin� wnstruction or the peAormance of <br />consl�uctj�n. Th�l I ar}� authorized by the owner of lhis property to perform the work for which application is rr�ade and I comply with the <br />Stafe Cm�tFactor �La�k;1827 RCW and 296200 WAC. <br />