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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 />Y ' /� � � �4.�z <br />LEGAL LOT N0. BLO�K <br />DESC. <br />OWNER <br />�/C?h/1L. �iN.jl/'�n�j <br />iENANTNAME <br />Ow�cr" <br />�L�IIy- Sfr✓:C�S �f Sno. Co. <br />CONTR. LICENSE N <br />�l_f�/O�_$ 2 y30{-1 <br />USE OF BUILD�NG <br />siti��ti �n..,.l�� IQ�s.o�tnrt, <br />PARCEL TAX I.D. 8 <br />TRACT OR SUBDIVISION K <br />�y.�� r�l��� A� <br />CONTAC7 FOR PERMIT <br />�F� P�ku-d <br />�1a� �{Y� ,l��r c.U. slr. D <br />HEATSOURCE <br />X Electric _ Gas _ Olher <br />WORK DESCRIPTION / <br />R*.��O�f t'k�s�i�,5 �11nf�r G.�c,�r,- �^� �-t��C�rc. „iI.1 �. r�cv <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler healer <br />_ Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinai <br />Dnnking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />PERMIT N <br />PHONE H?S-JS`�-S-i09 <br />��i�,k �'�r� <br />S'Fr��i <br />v2� -d9o-��� u <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Forced air systems <br />Gas riping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit hoaler <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />!'ITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify thal I have read and examined lhis application and know the same to be Irue and correct. AII provisions of laws and <br />ordinaces goveminc� Ihis type ot work will be complied with whether specified herein or not. The granting of a permit does nol presume <br />to give aulhoriry to viotate or cance� Ihe provision of any olher stale or local law regulating construction or the performance of <br />construction. Thal � am authorized by lhe owner of lhis property to perform Ihe work tor which application is made and I comply with the <br />State Centractors Law 18.a7 RCyV and 296.200 WAC. <br />