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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-6857 — wuvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRF�33 <br />l� Ol `� - �.�✓ <br />LEGA LOT NO. BLOCK <br />DESC. <br />PARCEL TAX I.D. N <br />TRACT OR SUBDIVISION k <br />PERMIT M <br />k�i ��� L"l��`�k �1)� 1uc�E�^ S�-5�c�2�� 'iy�-�-c y��-3�b`i5��� <br />TENANT NAME CONTACT FOR PERMIT PHONE �1 �, _� ��_ �� ��-� <br />� r^ <br />1�,�L�.Q1'1�-� ��cr.�i�c��7 �. a- 4.���� L���-�t'�- _ E-M�i��.t�c�wic '3��'vaGt <br />CONTR. LICENSE N <br />USE OF BUILDING <br />HEAT30URCE <br />Eleclric Gas Other <br />WORK DESCRIPTION <br />��.,e-- ,��C,�� �,,t��.-��� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BatMub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barlmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease irap <br />Rooi drains <br />Other <br />� <br />NO. <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air �yslems <br />Gas piping <br />Water heater <br />Ges fireplece <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exheust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF tI�ERETT LOCAL SAIES TAX CODE IS 3705 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances governing this lype of work will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />to give authority to vidate or cancel the provision oi any other slata or local law regulating construdion or the performance of <br />construction. Thal I am authorized by the owner of this property to perfortn the work for which application is made and I comply with the <br />Sta(e Contractors Law 18.27 RCW and 296.200 WAC. <br />�;.. �,_A., . � < < �� s���l �n <br />