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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 ADDRESS <br />�j2� 3 t L-�,QFND lY(/� <br />LEGAL LOTNO. BLOCK <br />DESC. �� '�. � b �V I� <br />M �.M�o-z �a <br />TENANT NAME <br />�w ��_ <br />CONTR. LICENSE # <br />USE OF BUILDING <br />WORK DESCRIPTION <br />G��� <br />��-Qvu�' C�i2��� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavalcry (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />W aler healer <br />Sink (service/bar/mop/etcJ <br />Back(low prevenler <br />Urinal <br />Drinking Founlain <br />Flocr drain <br />Grease trap <br />Roo( drains <br />Other _ <br />PARCEL TAX I.D. # <br />va 3 - � <br />TRACT OR SUBDIVISION # <br />I b � 20 �t 5�`-` /a� �E <br />CONTACT FOR PERMIT <br />M iurontt_ ru a-r�T � <br />�/� HEAT SOURCE <br />� <br />Eleclric Gas Other <br />j v X 20 ('�u, �'J �nls"7 <br />�0. <br />�] <br />S-.SaI� (oo l,� <br />5'�•S'a I • (ot� 1,� <br />CONTRACT PRICE UF WORK <br />N TYPE OF FIXTURE OR ITEM <br />A/C— Irhandlingunits <br />Forced air systems <br />Gas piping <br />water heater <br />Gas f repiace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woadstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify tliat I have read and examined this application and know lhe same to be true and correct. All provisions of laws and <br />ordinaces governing this rype of work will be complied wilh whether specified herein or noL The granting of a permit does nol presume <br />to give authoriry lo violate or cancel the provision of any olher state or local law regulaling construction or the performance of <br />construciion. Thal I am authorized by lhe owner of lhis property to per(orm lhe work for which application is made and I comply with the <br />State Contractors Law 18.� RCW a�6.200 WAC. <br />