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'��1C��'�� CITY�O EnVERETTPP RIMIT�SERV' CES <br />� 3200 CEDAR STREET, EVERETT, bVA 98201 <br />�]�}��� (` 425-257-8810 - FAX 425-257-8857 - www.everettwa.org q p <br />� I� � � '11- S <br />APPLICATIOPJS ARE ACCEPTED FROM 8 AM T O 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />LOT <br />or����� <br />BIOCK I TRACT <br />�„�_.+ <br />PARCEL TAX I.D. # <br />y <br />/ <br />� <br />GONTRACTOR �-{-� �r^ � 1 Ti A��RE55 GIIT/[IY <br />1 G ��1J /, <br />CONTR. LICENSE # � �� "/�0 5�0� o a 30 ��. o 0 <br />v <br />USE OF BUILDING I HEAT SOURCE <br />�U l �..D j i�-o A�� �� I A � L — Electric � Gas _ Olher <br />WORKDESCRIPTION G�S-�yU�-� �j f Lt S,�{�1�I{� j f'QY�'f <br />.j�"�^� c�.w�S25 t�r= o f c-,1'1 �/ w.LC�s' st�tl Co,u,N'� <br />�� '� IIY /�"Y'0�'�lut'w'�'S'�/ �Gv►'��/diq ; c��^)�i �$�'C,�Yt <br />��" � � <br />l�Lv�Gl �1�+4 GLCCes s'i��u � 'f�-I - - <br />NO. I IYPE OF FIXTURE OR ITEM <br />Toiiel <br />Bathtub <br />Lavatory (wash ba,in) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains . <br />PRICE OF WORK <br />, pv O , <br />7, �So S- f� v�'�� <br />s � �,��•i�stS a.1�( � l <br />� vl�fh���, l�F� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />\Forced air systems <br />� Gas piping <br />5 Water healer <br />� Gas fireplace <br />Gas range <br />'Clothes dryer <br />(tenge hood <br />� ExPfaust fan <br />Unit heater <br />Boiler <br />Refrigeratior� <br />Woudstove \ <br />Other <br />�. <br />CITY OF EVERE7T LOCAL SALES T/U CODE IS 3105 <br />I hereby centify that I have read and examined this applicalion and know the same to be We and correct. All provisions of laws and <br />ordinaces goveming this type o( work will be complied with whelher specified herein or not. The granting of a permit does not presume <br />to give authorily to violale or cancel lhe provision of any other slate or local law regulating construction or lhe performance of <br />construclion. That I am authorized by the owner of this property to perform the work for which applicalion is made and I comply with the <br />State Con¢acRnshaw.18.27 RCW and 296.200 WAC. <br />� <br />