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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERfcTT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />3-d2-o� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 6 CREDIT CARDS ARE NOT ACCEPTED <br />LOT NO. <br />DESC. <br />�NT NAME <br />���� <br />� PARCEI. TAX I.D. • <br />BLOCK TRACT <br />ADDRESS <br />�aZ�, `�5 � ���� <br />I CONTACT FOR PERMIT <br />CONTRA R � ADDR 3 � ' • <br />�la.t-r� U� a I �7� �l�'l�v�.� <br />CONTR. LICENSE R .7 _�. .n , , � ..., i-. . _ �v . .» <br />USE OF BUILDING <br />WORK DESCRIPTION <br />N0. I TVPE 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/mopletc.) <br />BackBow preventer <br />Urinal <br />Drinking Fountain <br />Floardrain <br />Grease trap <br />Roof drains <br />Olher <br />HEATSOURCE <br />_ Electric ✓ Gas _ Other <br />N0. <br />��v � -c�ve� � <br />PHONE <br />�L�0-73�� <br />/_ PHONE nl A �2Z. <br />r�� ,�flJ �l �l7 <br />� <br />CONTRACT PRICE OF WORK <br />Lln .�;..,� <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas range <br />Cbthes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretien <br />Woodstove <br />Other <br />CIN OF EVF.RETT LOCAL SALES 7AX CODE IS 7705 <br />I hereby ceritify that I have read and examined this aF.plication and know the same to be Lve and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />to give authoriry ro violate or cancel the pmvision of any other state or local law regulating construction or the perfortnance of <br />cons uction. That I am authorized by the owner of this property to peAorm the work for which application is made and I comply with the <br />St ctors aw 1827 RCW and 296. 0 WAC. <br />A����,� .`�-1�,� �,� �1�� 1,�� � <br />