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SITE ADDRESS <br />2 � <br />LEG�L LOTNO. <br />DESC. <br />OWNER <br />���� <br />TENANTNAME <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 6 AM TO 4 PM <br />PARCEL TAX I.D. # <br />)� l ���\Z�i.-l.aU \ <br />BLOC!( I TRACT <br />CONTACT FOR PERMIT <br />CONTRACTOR • /..- ADDRESS �.� � � <br />�(i/�5N/N�`7'f1J �v:$T�' ��$J., <br />�i(� �c � /.'�y <br />CONTR. LICENSE k [ � ' � � <br />CU��Ji��,� /��L, r <br />USE OF BUILDING <br />HEATSOURCE <br />Electric ,� Gas _ Olher <br />. a..3 _07 <br />PERMIT tF <br />PFiONE n <br />�L.,.r�1� � ��D <br />PHONE <br />„� <br />�'3 S� <br />�S-c�r ' <br />y� s' r5�'�' <br />CONTRACT PRICE OF WORK <br />WORKDESCRIPTION J �,L�` I �. ,{ „ � <br />C�\Cl�'��G. C� (.�-r � �C2 S �\�2 �.�.���_ <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 Uay <br />Sink (service/barlmopfetc.) <br />Backflow prevenler <br />Unnal <br />Drinking Fountain <br />Floor drain <br />Greasetrap <br />Roof drains <br />Olher <br />Np, I T'PE OF FIXTURE UR ITEM <br />A1C - air handling units <br />Fcrced air systems <br />Gas piping <br />� Water heater <br />Gas fire�lace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pumr <br />Unit heater <br />Ooiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby cenliry that 1 have read and examined this application and know the same to be true and correcl AII provisions of laws and <br />ordinaces goveming this type of work will be complied with whether specified herein or nol The granting of a permil does not presume <br />ro give au!hority lo violate or cancel the provision of any other stale or local Iaw regulaling construdion or the pe�formance of <br />consWction. That I am authorized by the owner of this property to perlorm the vrork for which application is made and I comply with the <br />Slate Contradors Law 1827 RCW and 296.200 WAC. <br />T <br />