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SITE ADDRESS <br />DESC. <br />PERMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881C – FAX 425-257-8857 – www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 HM TO 4 PM /� -QQ —� <br />PARCEL TAX I.D. # PERMIT # <br />,� MD�112- ��`� <br />BLOCK TRACT OR SUBUIVISION # <br />_....-.- „ � I /.JG� �lG /�C <br />� I ,._�_ <br />���-- - <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />E•MAIL <br />CO TRACTOR �//'- j+���/f! <br />l.'r/b� ,�� �� �� � <br />CONTR. LICENSE # _ _ _ , _ <br />USE OF BUILDING <br />� <br />WORK DESCRIPTION <br />S, f � ,�i,�r > <br />— PLUMBING <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washcr <br />Waler heater <br />Sink (service/badmop/elc.) <br />Backllow preventer <br />Urinal <br />Drinking Founlain <br />Floordrain <br />Grease trap <br />Roo( drains <br />Olher <br />���sJ!-C/ <br />HEATSOURCE <br />_ Eleclric 1'��-Gas__. Olher <br />NO. <br />"i �ij -��� <br />CONTRACT PRICE OF WORK <br />C d 0 <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handlin9 units <br />Forced air syslems <br />Gas pi� '� <br />Waler healer <br />Gas (ireplace <br />Gas range <br />Clolhes dryer <br />Rango hood <br />Exhausl lan <br />Hcal pump <br />Unil healer <br />Boiler ' <br />Refric�eralion <br />Woodstove _Du.�^�'r <br />Other <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />� hereby cerilify Ihal I have read and examined this applicalion and know the same lo he Irue and correcL All provisions oi laws and <br />ordinaces c�oveming this rype o( work will be complied wilh whelher specified herein or noL The granling o( a permil does nol presume <br />to give aulhorily lo violate or cancel the provision ol any olher state or local law regulaling consiruction or the per(ormance of <br />conslruction. That I am aulhorized by Ihe owner of lhis properly lo per(orm lhe work (or which applicalion is made and I comply wilh lhe <br />Stale Conlraclors La�v 18.27 F?CW and 296.200 WAC. <br />