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. �,2U�ZUlq'(� <br />� <br />SITE ADDRESS <br />7 <br />LEGA LOT NO. <br />DESC. <br />OWNER <br />,/ Sv � <br />TENANT! E <br />CONTRACTOR�� <br />CONTR. LICENSE / <br />USE OF BUILDING <br />WORK DESCRIPTION <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />P/1RCEL TAX I.D. N <br />Tancr <br />CONTACT FOR PERMIT <br />�eio3.v� 6s�� <br />HE�TSOURCE <br />Eleclric �,Gas_Olher <br />NU. I TYPE OF FIXNRE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Oishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (servicell�ar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />RooF drains <br />Other <br />/,3p v <br />��.,,.�: <br />�/_ig _,2 <br />PERMIT t <br />s/Z <br />yt.�gB � �79'Z <br />���t � - 79 z a <br />CONTRACT PkICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Cblhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J106 <br />I hereby ceritiy thal I have read and examined this app�ication and know lhe same to be We and cortect. All provisions of laws and <br />ordinaces gove� ning this type of work will be complied wilh whether specified herein or not. The grenting of a pertnit does not presume <br />to give authoriry lo violate or cancel the provision oF any other stale or local law re�ulaling consWction or th.e performance of <br />construction. That I am authorized by the owner of this proF�:ity to perform lhe work for which epplication is made and I comply with the <br />State Contraclors Law 18.27 yiG'V9 and 296.200 WAC. �� <br />