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PE�rtMIT APPLICATIO� <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 />—��PPLiC.4TIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT $ CREDIT CARDS ARE NOT ACCEPTED <br />SITE AJDRE�S _ i . <br />7 (�� <br />LOT NO. <br />TENANTNAME <br />GONTRACTOR %' �S� �! <br />CONTR.LICEHSE1N, (���� <br />USE OF BUILDING <br />BLOCK � TRACT <br />PARCEL TAX I.D. A� <br />�1� 1 � YYk� L <br />CONTACT FOR PERMIT <br />��.uC� U�� <br />ADCRESS <br />Do. iyaa <br />HEATSOURCE <br />�Ias-,�3 -�� 1 <br />CITY/11P PHONE <br />��h. 9$a:q � ya � �� <br />_ Gas _ Other <br />WORK DESCRIPTION �e WV'��' ( L� � <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />_ Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />_ Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />� Drinking Fountain <br />Floor drain <br />_ Grease trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />:.! � 7/"> Q <br />NO. I TYpE OF FIXTURE OR ITEM <br />_ fvc—airhandlingunits <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heatpump <br />Unit heater <br />_ Boiler <br />Refrigeration <br />Woadstove <br />Other <br />CITY OF EVERETT LOCAL SAIES SAX CODE IS J105 <br />I hereby ceriti(y that I have read and examined this application and know the same to be lrue and corcect. All provisions of Iaws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authonry to violate or cancel tha provision of any other state or local law regulating constructlon or the performance of <br />construction. That I am authorized by the owner of this property to per(orm the work for which application is made and I comply with the <br />State C tractors Law 18. 7 RCW and 296.200 WAC. <br />� 1� �.�- 1�-- �la�lo� <br />