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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8t310 — FAX 425-257-II057 — www.evereriwa.org <br />SITE ADDRESS <br />r O <br />LEGA LO ND. <br />DESC. <br />WNER <br />� �- `� <br />TENnNTNAME <br />cONTRAC .��y�p� <br />CONTR. LICEN9E p <br />3Ct�� <br />USE OF BUILDING <br />sr� <br />APPLICqTIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />-c� <br />I.D. iF <br />TRACT OR SUBDIVISION R <br />CONTAC7 FOR PERMIY <br />J� rn� z �� Q�L�n.�,a.r� <br />HEATSOURCE <br />_ Electric �Gns _ OUior <br />PERMR 7f <br />> Nl �Z � i �C?� <br />PHONE <br />�a� � �1� . 8'�-a o <br />PHONE ` (�� � a �j � GO <br />l. V�i-4�-t. �, „�C1� .� ��c a� OC�c',c m <br />�j Q�I� c, � <br />CONTRAC7 PRICE OF WORK <br />`�q q <br />WORK nE3CRIP710N <br />'�e,�avz. �2.�i S�� i� C�{ Q 3 �v � Ra c.�e , L� l�` -�or l:i <br />NO. I 7YPC OP FI%TURE ON ITEM <br />Toiiet <br />Bnthtuh <br />Lavatory (wash �asin) <br />ShoHrr <br />Kitchen sink 3 disposal <br />Dishwnsher <br />Clolhes wnsher <br />Weter heater <br />Sink (service/barlmoplolc,) <br />Backflow ptevenlar <br />Urinal <br />Orinking Fountain <br />Floor droln <br />Grease trap <br />Root drains <br />Other <br />NO. � 7YpE OF FIXTURE OR ITGM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heeler <br />Gns firoploce <br />Gas ranpe <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />unit heatni <br />6oiler <br />Refngeration <br />WOod,tovr. <br />Other <br />CITY OF EVGRETT LOCAL ShLES TAX CODE IS 3105 <br />I hereby certiy thal I hovr. read and examined this application and know the same b be troB and correcL All pfOvisions of 18ws and <br />ortiinances goveminp this type ot v.�rk will ba compl�ed with whetherspecified herein or not The granting of e permit does not presume <br />tn give aulhority to violt�te or cancel tha provlsion of any olher state or local law regulating construction or t�e pertormance of <br />cons ction. That I am authonzgggd by Ihe owner of lhis property lo pedorm the work forwhic� applicaUon is made and 1 wmply wi�h lhe <br />Stntc�onlradors Law 18 27 jiC�N and 2.200 WAC. I ` <br />/� -, � . „� � 11 Ir !in <br />