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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 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE <br />BLOCY. <br />DESC. <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION # <br />PERMIT # <br />��p��-�p� <br />(�(���Qi�.��l �QlJ/-cJ Gl ��.5 % - �it�11,;� ?l�G9/ 7o�.Jr'.,�1� cXP�/<' <br />�T NANT NAME I CONT CT FOR PERMIT PHONE <br />E-MAIL <br />A I <br />CONTR. LICENSE R � (�(,� /t�� <br />USE OF BUILDING <br />HEAT SOURCE <br />1=lectric Gas Other <br />WORK DESCRIPTION <br />�� /Yl � !�'�'�c'Y�— <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink R disposal <br />Dishwasher <br />Clolhes wa:.'�er <br />6;aterheater <br />Sink (serv�:elbar/mop/elc.) <br />Backilow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas Tireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit h�ater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERE7 i LOCAL SALES TAX CODE IS 3105 <br />I hereby certify Ihat I have read and examinad this application and know the same to be true and correct. All provisions o( laws and <br />ordinances governing this type ot worh will be complied with whether specified herein or not. The granting o►a pertnit does not presume <br />to give authoril,v to violate or cancel lhe provision of any other state or local Iaw regulating construction or the pe�(ortnance of <br />construction. That I am aulhorized 6y the owner of Ihis property to peAorm the work (or which application is made and I comply with the <br />Stat�Contracbrs La�18.27 RCW and 296.200 WAC. <br />