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I <br />P�.r�IVIIT AP�LfCATIG�� <br />CITY OF EVE�ETT PERMIT SERVICES ,-y-os <br />�� 3200 CEDAR STREET, EVERETT, WA 9820'i <br />425-257-8810 - FAX 425-257-fi857 - www.everettwa.org �t�/a�/ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT � CREDIT CARDS ARE NOT ACCEPTED <br />LOT NO. <br />DESC. <br />/`f�U K �` <br />CONTRACTOR /"�' <br />CONTR. LICENSE # � <br />� <br />USE OF BUILDING <br />WORK DESCRIPTION <br />%�� v� PARCEL TAX I.D. # <br />��aP�'!j� Iv.. A G o .�-- <br />BLOCK TRACT <br />a.v J1 Soc�r! ��rk �j� <br />ADDRESS <br />!_ee �r/� !1''�' 9jG° li� � <br />�� � --- � - CONTACT FOR PERMIT <br />i';�,,,,.� � �'L` SoNFr ti/oan� <br />i <br />'r <br />�P��/ ���s'�7-uc-%��.� <br />PLUMBING <br />iJO. I NPE OF FIXTURE OR ITEM <br />Toilet <br />�athtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwashef <br />Clothes washer <br />Laundry tray <br />�'✓ Sink (service/badmop/elc.) <br />� BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />_ Grease trap <br />Roof drains <br />Other <br />� <br />T# <br />( � — Uc� <br />�b •- �–lw— iD/o <br />A6DRESS CITY2IP PHONE <br />a, � ���� mv � ���• � P <br />�'c�t �v. q i oio <br />HEA'f SOURCE <br />_ [lectric _ Gas _ Other <br />� �����N s�� � <br />�o'x� ` <br />CONTRACT PRICE OF WORK <br />.� / I f> c� U <br />NO.� TYPE OF FIXTURE OR ITEin <br />A/C – air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas (ireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />ReGegeration C �R'r� ���r, <br />Waodstove <br />Other <br />CITY OF cVERETT LOCAL SALES 7AX COOE IS 7105 <br />I hereby ceritify lhat I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing ihis rype of work will be complied with whether spec!fied herein or noL The granting of a permit does not presume <br />to give authoriry !o violate or cancel the provision of any other state or local 'aw regulating construction or the performance of <br />construction. ��hat I am aWhorized by the mvner of this property to per.'orm the �vork for svhich application is made and I comply with the <br />State ConV. ctors L;v� �fi.�' .C'd/ and 296.200 WAC. <br />�^�`A <% ' / `�/�� <br />Sir,nature cf C�,vne antrac:cr.rathorized Agant Date �/�� <br />/ <br />