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PLIRMIT APPLICATi&4 <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25'-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />LOT NO. _ I eLC <br />TENANT NAME <br />C/uV <br />PARCEL TAX I.D. # <br />Ocp 393 300a !! 7aa V <br />!!//litilrrf PHONE <br />//��/9.0 <br />/ V / <br />CONTRACTOR 07 �C.rI-, / ADDRESS y1 � LSi SC CITY/ZIP PHONE <br />C 7NTR. LICENSE # G'Ne^r <br />USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br />CONTACT FOR PERMIT <br />_ Electric _ Gas _ Other <br />WORK DESCRIPTION <br />4ilr7't 9l <br />AIIAched <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (serviceibadmopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ A/C — air handling units <br />_ Fbrced air systems <br />_ Gas piping <br />_ Water heater <br />_ Gas fireplace <br />_ Gas range <br />_ Clothes dryer <br />_ Range hood <br />_ Exhaust fan <br />_ Heat pump <br />_ Unit heater <br />_ Boiler <br />_ Refrigeration <br />_ Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <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 />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authonty to violate or cancel the provision of any other state or local law rr;gulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate Contractors Law 18.27 RRC,Wno 296.200 WAC. <br />