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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 / 2 _��n �llj <br />f <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT # <br />2yz��-t�J, h1u1C.1�-�� �1�d +M�ul� -,��-3 <br />LOT NO. I BLOCK I TRACT OR SUBDIVISION # <br />DESC.r <br />OWNER <br />`( ✓�✓1 �/ Ih � ��- Z- <br />TENANT NAME <br />AN„ �I l� \.. � <br />S�� 4 <br />NSE N <br />USE OF BUILDING <br />WORK DESCRIPTION <br />i� S�S��,MJ Zn C. <br />CONTACT FOR PERMIT <br />�iti � a� •tZ r <br />HEATSOURCE <br />g1.o3 �4zs)3SS-7.14 <br />PHONE <br />ly2�j238-G�2(� <br />_...._.. �,,o> c�c�8 -�14 y 8 <br />� J C Jn J�.7 w�..5 �� `I O Z�'f (o <br />� Electric _ Gas _ Other <br />�.�,��11 c, r�,�s„�b���,t � 1��.-1 1�.,.. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toiiet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler healer <br />Sink (service/badmop/etcJ <br />Backflo�v prevenler <br />Uri�al <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gasfreplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />i hereby certify that I have read and examined this application and know Ihe same to be true and correcL All orovisions oi laws and <br />ordinances governing this lype of work �vill be complied with whelher specified herein or not. The granting of a permit dces not presume <br />to aive aulhority lo violate or cancel lhe provision of any other state or Iocai law regulating construction or Ihe pertormance of <br />conslrucfion. That I am authorized by the o�vner of this property to perform the work tor which app�ication is made and I comply with the <br />R�aie CoMrac�ors Law 18.27 RCW and 29G200 WAC. <br />