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: <br />PERMIT �►PPLICATION <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 PM <br />SITE ADDRESS PARCEL TAX I.D. i? <br />_�� ,.�1� ,� � �lG� �ier�z�'�f1 „G-�.'�' y3 91�6 9c�' �x � <br />LEGAL LOT� O. DLOCK pTJRACT O/R SUBDIVISION # �/ / <br />DESC. l� �%G•'� /�1Lz` �/ �dPI.E� rh (y�Cl�j•�C 3 HS i <br />TENANT NAME <br />CONTR. LICENSE 8 <br />USE OF BUILDING <br />%Ie'S� i�r�.� �-�� <br />, L' �''21���� <br />CONTACT FOR PERMIT PHONE� <br />. / <br />> <br />�` � � � � E-MAIL <br />HEATSOURCE <br />� Electric _ Gas _ Other <br />PERMIT # <br />-,].7.Y -F�G YY <br />�i.9'�— 3.c'Oi <br />CONTRACT PRICE OF WORK <br />�� VV" <br />WORK DESCRIPTION ����� Lp��1'1.c'oMJ' If«=fi-�lc.� ZGL{L/rlt�l/ <br />9 °� " <br />��J,�,� -�,a s ��,�ti� � �I� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BalhWb <br />Lavatory (wash basin) <br />Shower <br />Ki�chen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler hea�er <br />Sink (service/badmop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />� <br />�— <br />� <br />� <br />A/C - air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gasfreplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />NJoodslove <br />CITY OF EVERETT LOCAL SAL[S TAX CODE IS J105 <br />I hemby certi(y lhal I have read and examined lhis application and know lhe same to be �rue and correct. All pro��isions of laws and <br />ordin�nces goveming this type o( work will be complied with whether specified herein or not. The granting of a permit does nol presume <br />to give authority to violate or cancel the provision of any other state or loral law regulating corsiruction or the performance o( <br />consiruction. Thal I am authorized by lhe owner of �his propeAy to per(orm itie work for which applicalion is made and I comply wilh the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />i,'i� � �_ : . _ <br />'--� <br />