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a <br />PERMIT APPLICATION <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. # <br />S%>y `c7r: i 25o�,) `/o3 <br />LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION # G-7 <br />DESC. _---- I <br />SCO <br />TENANT NAME <br />•2'26y ar"Ikej <br />CONTACT FOR PERMIT <br />CONTRACTOR <br />CONTR. LICENSE # A&AA &1 W% C-T3 `i 91 U' <br />USE OF BUILDING <br />WORK DESCRIPTION <br />LA RC�cCCJ�- Qn5 <br />NO. I T: PE OF FIXTURE OR ITEM <br />_ Toilet <br />_ Bathtub <br />_ Lavatory (wash basin) <br />_ Shower <br />_ Kitchen sink & disposal <br />_ Dishwasher <br />_ Clothes washer <br />_ Water heater <br />_ Sink (service/barhnop/etc.) <br />_ Back^,ow preventer <br />_ Urinal <br />_ Drinking Fountain <br />_ Floor drain <br />_ Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />Electric S Gas _ Other <br />o � <br />70)7� <br />'ITy21P <br />i�(�t <br />PHONE <br />EMAIL <br />IrTLPp cl <br />U 9bro&'a <br />!/ -ao <br />PERMIT # <br />PHONE <br />QSles' Z�G - 3s6 -� <br />tip- 8isi-�9z� <br />PHONE <br />4tj--r �97v <br />CONTRACT PRICE OF WORK <br />,116do <br />N-.c) jCK5 V- -AAtt- <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or rot. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. Th t i am authorized by the o le <br />of this property to perform the work for which application is made and I comply with the <br />Slate Contrasw 8.27): 6.200 W AC. <br />