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PERMIT APPLICATION <br />CITY OF EVE�ETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org 3_o �-0 6 <br />APPLICATIONS ARE ACCEPTED FROM 8 P.M TO 4 PM - DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br />�- �� �-t�� <br />LOT NO. BLOCK <br />DESC. <br />TEN NT NAME <br />��r,�z,c.t� <br />CONTRAClipR , 1` �J � <br />�<i% L � <br />CONTR. LICENSE / �'1 _„ .n , . � �,. . <br />USE OF BUILDING <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE 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/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor dram <br />Grease trap <br />Roof drains <br />Other <br />PARCEL TAX 1.0. �I <br />SRA�T <br />�-/z�5 �-'? <br />ACT FOR PERMIT <br />�A1DDR�EIS � • ��,/ G�TnIZIP <br />1���?`���������' l.�[.���1-.n. <br />HEATSOURCE <br />_ Electnc V Gas _ Other <br />�-���I �. <br />PER IT N , � , � <br />.'%' '��� <br />PHONF <br />'�-C '�� <br />PHONE <br />%��a0 -�733� <br />/� PM( iiE <br />' /C'��, :�'C� 73.3`i� <br />?� <br />CONTRACT PRICE OF WORK <br />�-- D <br />�.��k;�U `� - - <br />���2.� � <br />NO. I TY�E OF' Fi%1URE OR Il'�M <br />. i <br />A/C – air handling ur�its - <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boi�er <br />Refngeration <br />Woodstove <br />Other <br />CITY OF EVERETT LnCAL SALES TAX CODE IS 7705 <br />I hereby cerihfy thal I have read and examined this applicauon and know the same to be true and correct. All provisions of laws and <br />oidinaces governing this type of work wlll be complied with whether specified herein or not The granting of a pertnit does �ot presume <br />to give authonry ro violate or cancel the provision of any other state or local law regulating construction or the performance of <br />const,�uctioa That I am authorized by the owner of tnis property to perform the work for which application is made and i comply with the <br />Sta7�yr �ry7ctors�`a—w 18� 27 RCW and 296.�p\0 WAC. �� <br />/.���//.9.f . L�lA/AA/. 1 C4�,1/.'l <br />��. <br />