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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - w�w+.everettwa.org i_�� _ �� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE81T 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRE� PARCEL TAX I.D. # .rr.Kmi i a <br />�� O/J G-f��t,'� �� %J� oG �" S 3 �-a�7-�''�'"a' /; -'/�%-�' <br />LEGAL LOTNO. BLOCK TRACT <br />DESC. <br />Ltl �".� <br />TENaNTNAME <br />�C�Nhl�in6N Z�'6' <br />CONTRACTOR D������ <br />CQNTR. LICENSE # <br />USE OF BUILDING <br />WORK OESCRIPTION G,� S <br />ICONTACT FOR PERMIT <br />ADDRESS �d M� <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />PHONE <br />�?s 2�9 �o��C� <br />��ryZp PHONE <br />CONTRACT PNIGF Oh WUKK <br />�i��G �orC Sl�ot.� .'u� F�v2�dcF <br />NO. I TYPE OF FI%TURE OR ITEM <br />_ Toilet <br />Ba�htub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 6 disposal <br />Dishwasher <br />Clothes washer <br />Laundry iray <br />� Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinai <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Rooi drains <br />Other <br />ryp, I �fYPE OF FIXTURt OR ITEM <br />A/C — air handling units <br />% Forced air systems <br />T Gsa piping <br />Water heater <br />Gas Lreplace <br />1 Gas range <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refnger:+tion <br />Woodstove <br />O1hEf <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 7705 <br />I heretry centify that I have read and examined this application and know the same to be true and correcl All provisions of laws and <br />ordinaces govort��ing lhis rype of work vnll be complieA wilh whelher specified herein or noL The granting of a permit does not presume <br />to give aulhonty to violate or cancel the provision of any other state or local law regulating consirudion or lhe pertortnance o( <br />construction. That I am aulhorized by the owner o1 lhis proporty ro peAorm the work tor which application is made and I compty with the <br />State CoNractors Law 18 7� W a�` 6.200 WAC. � <br />l�.n � ��/G ( �i.�.,_ _ /I/17%6 i/ <br />� <br />