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P'�RMIT APPLICATItrN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everoriwa.org <br />APPLICATIONS ARE ACCEPTED FROM s AM TO 4 PM - DEBIT i CREDR CARDs ARE NOT ACCEPTED <br />sITE ADDRESS • PARCEL TAX I.D. N ��R � <br />z ,� l�w,�t� ��r �s.�o�-3 <br />Le� ��� ��. i e�TocK —I TRACT <br />DESC. <br />C( �� `rl ( <br />CONTRACTOR <br />NtC� rs �i a.Q.( S y N f <br />CONTR. LICEN3E t,�,, A t� S�f( S� j k g g <br />USE OF BUILDINO <br />WORK DESCWPTION � N� � A L L <br />��i� �� �ST u��" <br />NO. I TYPE OF fll(TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/elc.) <br />Backlbw preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drdins <br />Olher _ <br />ti(d f S �� <br />�noReaa <br />Z 1l2 <br />- F <br />r��arR y � s � <br />�( j< <� k s zS�'r' 6 <br />� ve � e.C7 <br />A �/t <br />HEATSOURCE <br />_ Electric _ Gas _ OIF,er <br />cmmP P� — <br />C�-r Yz; zs� d�o l <br />-in- <br />CONTRACT PRICE OF WpRK <br />s��tis Y'Xio-` �iu�,. 14�����.. <br />�'`7�1e � W � ST t,e� � • <br />— /%ar�- �ll,,.,,. <br />N0. I TYPE OF FOfTiME OR ITEM <br />A/C — air handlirg units <br />Forced air systems <br />Gaa pipbtg <br />Water heater <br />Gas fireplace <br />Gasranpe <br />Gofhe� dryer <br />Rarge hood <br />E#�awt lan <br />Heal P�P <br />UnK heater <br />BONer <br />Rehigeratlon <br />Woodsbve <br />OU�er <br />CRY OF EVERETT LOCAL SALES TAIf CODE IS �105 <br />I hereby ceritily Ihat I have read and examined this application and kraw the eartie Ip pe Uue and cort�, qN p�p�y a�� <br />ordinaces goveming this type of work wi% be �omplied wilh whefhe� s�cifi� �n or noL The prantlnp pf a parrN� doss not p�� <br />to give aulhoriry lo vblate or cancel the provision of any oMer state or bcal lew regulatlng oonepuctlp� pr y�s p�o�m� �( <br />construction. That I am authorized by the owner of thb propeAy to perform yb wpr� (p� �h �� � mads and ��py � p� <br />State Contr�csois �aw 1827 RCW�and 2g§.2pp yyAC. <br />7 - 12.- OS <br />'IL <br />