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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />�2i9 �������� <br />DESC. <br />PARCEL TAX I.D. # <br />LOT NO. I BLOCN I TRACT OR SUBCNISION # <br />PERMIT # <br />Mo�-�i -a�ll <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />E•MAII <br />NTRA T R A ORE S �P H N <br />CONTR. LICENSE # �G)�-�/�i'� <br />USE OF BUILDING <br />��C�— <br />WORK DESCRIPTION <br />� <br />��;:� /�� �--� <br />U <br />HEATSOURCE <br />_ Eleciric _ Gas _ Olher <br />���� - ��� <br />�,. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (serviceNadmop/elc.) <br />BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greaso trap <br />Roof drains <br />Olher <br />NO, <br />CON7RACT PRICE OF WORK <br />TrPE OF FIXTURE OR ITEM <br />NC - air handlinc� units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas firep�ace <br />Gasrange <br />Cbthes dryer <br />Ranc�e hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other _ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby ceritify that I have read and examined this applicatio� and know the same to be lrue and correct. All provisions of laws and <br />ordinaces governinc� this type of work will be c�mplied with whether specified herein or noL The granting of a permil does not presume <br />co give aulhority to violate or cancel the provision of any other slate or local law regulating censWction or the performance of <br />construction. That I am authorized by the owner of Ihis properly to perform the work (or which application is made and I comply with lhe <br />Stale Contrac4�rs La 18.�7 R_ and 296.<^00 WAC. <br />��"�i„ —� �l-2o v7 <br />