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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 />SIT ADDRESS <br />�3 303 I"Yl c. O <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />�C�C. �� " �11:.�� c:-7 <br />TENANTNAME <br />(—�u= SJCP��L� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION I <br />CONTACT FOR PERMIT <br />1 VA �k� � <br />0—iu� � yS , <br />CONTR. LICENSE ft ,w �.{ G� �''� 1 p� ��,� 1/�.�.v � 1 <br />USE OF BUILDING <br />WORK DESCRIPTION <br />S/Il� n.���c/ <br />l <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavatorv (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />water heater <br />Sink (sernce/badmoplelc.) <br />BackAow preventer <br />Urinal <br />Dnnking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />{�` L <br />PHONE <br />— i vv J <br />PERMIT# � <br />� oo -o o lv <br />PHONE <br />zs3-��;-Iz9 8 <br />E-MAIL ,,r� �� L F � �r ��(�jN++$ `�'S'T.Cn <br />HEAI' SOURCE CONTRACT PRICE OF WORK <br />Electric Gas Other <br />NPE OF FI%TURE OR ITEM <br />A/C — air hantlling uni�s <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unil healer <br />Boiler <br />Retrigeration <br />Woodstove <br />Other <br />CITV OF EVERETT LOCAL SALES TAX CODE IS J705 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances governing ihis type of work will be complied with whelher specified herein or noL The granting of a permit does nol presume <br />lo give authonry to violate or cancel the provision of an� other state or local law regulating consiruction or ihe performance of <br />wnstruction. That I am authorized by the owner of ihis property to perform the work for which application is made and I comply with the <br />State Conlracto�s�Raw 1827 RCW and 296200 WAC. <br />