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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 l PARCEL TAX <br />/7 �� bV. l�Iu. %i lt°b B lIJ O 22s y3 O�Oi <br />LOT N0. � BLOCK � TRACT <br />DESC. <br />PERMIT # <br />Dan (. � �e„aen /808 Da(I �'/ao� E✓er��kJy �yi�s��SS-7�7S <br />TENANT NAME CONTACT FOR PERh11T PHONE <br />�9.�sj35S a2i5" <br />Don ��ri.s�n e-rna� u..l,.nili.n�pvGrfZo� <br />I.VNIKA,pI:�IV�K�,,� C <br />CONTR. U� CENSE'#��✓ <br />USE OFBUILDING <br />I��mb/�� �I D/1 <br />�! i / �i� <br />� O �» �v-- �7��, �F <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />C�)3SS-�yzs' <br />CONTRACT PRICE OF WORK <br />WORKDESCRIPTION D�md�� 7 10%I � NOLtiQQ�� � V �S <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />W ater he2ter <br />Sink (service/bar/moplelc.) <br />Back(lo�v preven!er <br />Urinal <br />Drinking Fountain <br />floor drain <br />Grease trap <br />Roo( drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas tireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refric�eration <br />Woadstove <br />Other <br />CITY OF EVEREIT LOCAL SALES T/V( CODE IS 9105 <br />I hereby cerili(y thal have read and examined this application and know the same to be true and correct. All provisions of IaHs and <br />ordinaces governinc� this type of work will be complied wilh whether specified herein or noL The granting of a permit does �ot presume <br />tu c�ive authority lo v o�ate or cancel the provision of any other slale or local la�v re9ulating consWction or lhe performanc. �r <br />construclion. Thal I.�m aulhorized by the owner ot this property to perform the work for which application is made and I comply with the <br />Slale Conlraclors Lew 18.27 RCW and 296.200 WAC. <br />