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PErtMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />IGNqNINAMt <br />� �.. . <br />_..- . <br />CONTRACTOR <br />CONTR.LICEN6'M �p�T�p�. <br />•YK C1SL <br />USE OF BUILDING <br />WORK DESCRIPTION <br />�Ow ! N"Y*C C <br />TYPE OF FI%TURE OR ITEM <br />roilet <br />BathWb <br />Lavalory (H•ash basin) <br />Shower <br />Kitchen s:nk 8 disposal <br />Dishwasher <br />Clothes washer <br />Wa1er heater <br />Sink (service/badmop/etc.) <br />Backflow preventar <br />Urinal <br />Drinking Founlain <br />floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />PARCEL TAX I.D. A� <br />GONTACT FOR PERMIT <br />(L,� • �_f � <br />ADDRESS � <br />/�<.� ��� <br />S,� :: >,?�,��; <br />ylr � �r 9r'ry <br />PMVNE <br />S� �.f-';; l�- 2. <br />�f_{r7�f 9J7'{� <br />..,,; � � <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gasrange <br />Clathes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigeiation <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceritify that I have raad and examined this application and know the same to be true and correct. A�I provisions of laws and <br />ordinaces governinc� this lype of work will be complied wilh whelher specified herein or nol. The granling of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regutating construclion or the perfonnance of <br />construction. That I am authorized by the owner of this property to peAorm lhe work for which application is made and I comply with the <br />St�t@Contractois Law 18.27 RCW and 296.200 WAC. <br />�077�', <br />