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PtRMIT APPLICATION <br />CITY OF EVERETi PERMiT SERVICES <br />3200 CEDAR STREET, EVERE7T, W.4 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 <br />; <br />Z7i: �� i c°�>;'1�? �^ � r_�/Z , t <br />LEGAL LOTNO. I BLOCK <br />DESC. <br />/1�1 Y'IL'rr;t/�i <br />CONTR. LICENSE # . <br />L' � i.;� i� C�_ � �. <br />USE OF BUILDING <br />C' i r' /� /�� ' I'� � <br />WORK OESCRIPTION L� <br />� \C'�xcdt''_. i.� P1�-' 1��C�1�2�1 <br />NO. I NPE OF FIXTURE OR ITEM <br />Toilel <br />Oalhtub <br />Lavatory (wash basin) <br />Shower <br />Ki�chen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (serviceNar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drein <br />Grease trap <br />Root drains <br />Olher <br />PARCEL TAX I.D. # <br />TRACT <br />.j/ S l � Z "` � 'i'f"_�l1� <br />CONTACT FOR PERMIT <br />7 <br />/ <br />�C�''711j� �'U u'� �-�? ; t <br />ADDRESS <br />HEATSOURCE <br />���i��, <br />Eleciric _ Gas _ Other <br />P�RMIT.3' . <br />U �; ��� ' �— <br />UI rvLir rnvnc <br />N �i�5 i7i('o4ii <br />�c�,�1S I'vli-�Zu. 3yc 2�>3 <br />PHONE <br />,cc.-/,� Zc� 3�j�; .,.�g3 <br />CITYIZIP PHONE <br />I CONTRACT PRICE OF WORK <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Foroed air systems <br />Gas piping <br />Waler heater <br />Gas ireplace <br />Gas range <br />Clolhes dryer <br />Rangc hood <br />Exhaustfan <br />Heal pump <br />Unit healer <br />Boiler <br />Retrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br />I hereby ceritity that I have read and examined this application and know ihe same to be true and correcL All provisions of laws and <br />ordinaces governing this lype of work will �e complied wilh whelher specified herein or noL The granting o( a permit does not presume <br />to give aulhority to violale or cancel the provision of any olher stale or local law rec�ulaling construction or the performance of <br />construction. That I am authorized by the o�vner o( this property to perform lhe work for which appiicalion is made and I comply with Ihe <br />Slate ConUactors Law 18.27 RCW and 29G.200 WAC. <br />