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c <br />�' <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 />s��s��sslo cvs <br />I FGA LOT NO. <br />TENANT NAME <br />Sfl/�E <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� � <br />BLOCK <br />liVl� 1 nnv � ��� <br />FliF-,��� f��lJ/�� AvTI��/'z <br />CONTR. LICENSE # <br />USE OF BUILpING <br />5�.� <br />RCEL TAX I.D. # <br />-�id!- ov-a - �i a � <br />TRACT OR SUBDIVISION # <br />� Ca��yqv� <br />PERMIT # <br />y�.s��3. <br />CONTACTFORPERMIT �1,��n O 6.�96 <br />'oN /✓�fF. Q <br />E-MAIL <br />HEAT S RCE CONTRACT PRICE OF WORK <br />_ Electric Gas _ Other �9Q1 ��� � <br />WORK DESCRIPTION <br />�P��i��-��aG�l E�,Y/.rT��� ,e�.��pE-�« <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kttchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />BackFlow preventer <br />U�inal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NU. � TYPE OF FIXTURE OR ITEM <br />NC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerlify that I have read and examined this applicalion z�id know lhe same to be true and corred. All provisions oi laws and <br />ordinances governing this type of work will be complied with wl;=ther specified herein or not. The grantlng of a pertnit does nol presume <br />to give authority to vioiate or cancel the provision of any other state or local law regulating construdion or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which applica5on is made and I comply with the <br />Stale C�9tray(ors Law 18.27 RCW and 296.200 WAC. <br />