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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 — wvweverettwa.org <br />APPLICAT IONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />0.,2 o fU o_zk _1� <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC.j <br />OWNER ADDRESS CITY/ZIP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />CONTRACTOR � ! y` l'L ADDRESS cl co) CITYIZIP PHONE 5 <br />�Z <br />CONTR. LICENSE p <br />cz�(L(c <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Electric k Gas Other <br />WORK DESCRIPTION 1,7 n r1 <br />l}GQ. H1 UcY-cJC <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />Bathtub <br />Forced air systems <br />14 <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />Gas fireplace <br />I <br />Dishwasher <br />_ <br />Gas range <br />Clothes washer <br />Clothes dryer <br />_ r <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />J <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />1 hereby ceriti4 that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates ning this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give on to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />const Lion. at I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slat ontr or a 18.27 RC and 296.200 WAC. <br />�` <br />W <br />