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; <br />�tRMIT 4PPLICAYICvN <br />CITY �F EVEP�TT PERMIT SERVICES <br />3200 CFDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everett�ria.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESL <br />LOT NO. <br />TENANTNAME <br />Pi-� on �r��jJer�1; <br />CONTRACTOR Cwy� E � <br />CONTR. LICEt:SE # <br />USE OF BUILDING <br />�)�It'X <br />WORK DESCRIPTICN <br />��e � sl.�,�..sl-.� / <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />�Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />W aler heater <br />Sink (service/�ar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher _ <br />PARCEL TAX I.D. # <br />1'RACT <br />CONT0.CTFORPERMIT <br />L-��'� <br />ADDRESS <br />HEAT SOURCE <br />�,�L.Eiectric _ Gas _ Other <br />( z —// -Otc <br />PERMIT # <br />PHONE <br />CITYIZIP PHONE <br />I CONTRAC? pRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />tVC - air handling units <br />Forced air systems <br />Gas piping <br />W ater heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />lieat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAk CODE IS 3705 <br />I hereby ceritify that I have read and examined lhis application and know the same to be true and correcl. All provisi�ns of Iaws and <br />ort'naces governing lhis type of work will be complied with whelher specified herein or not. The granting of a permi: does nol presume <br />to give authority to violate or cancel the provision of any other state or local law regulating constn�ction or the peAormance of <br />construction. That I am authorized by the owner o( lhis prope�iy to pertorm lhe work for which a�plication is made and I comply with ihe <br />Slate ConlractflrsLa�_t8.27 RCW and 296.220 WAC. <br />