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� <br />', PERMIT APPLICATION <br />� CITY OF EVERETT PERMIT SERVI( <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettw� <br />SITE ADDRESS <br />}12� u�, �LtArit�E <br />LEG�L LOT NO. <br />DESC <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />v1E w R21vC� <br />BLOCK TRACT OR SUBDIVISION / <br />T[NANTNAME J <br />a y��- �1 (}y��/1S I �CNL�(1Civ� T <br />CONTRACTOR 4 t <br />RY H cni� t Ovcc <br />SG2v�cC5, rN� . <br />CONTR. LICENSE % <br />�,«.�oD� oFiBc.z� <br />USE OF BUILDING <br />2CsTr� ..��e n n� 7 <br />CONTACT FOR PERMIT <br />�ny s«{�c-g�Y <br />ADDRESS ,�� � ZT•.� <br />n�c s. <br />3 -a 3 i� <br />��«(��� �r� <br />C��9 1j�;�R 151010 <br />ngfn� 9�r� ,n . <br />e�� �Pub�;�REi` �'• <br />PHONEuj�.T2b• O`i4O <br />E-MAIL .�•`'J+r��4� �.I�,'� /'�':70oc,. <br />CITY2IP PH E <br />$EACTt-E�1+14 20b•7i6�C4j4L� <br />G£fICB <br />HEAT SOURCE CONTRACT PR�CE OF WORK <br />— — — � (Q�I�� , ov <br />Electric Gas Other <br />WORKDESCRIPTIOG �NSr'A(.IrAT-COn1 �=r ANSLI(_ {�102 FI(2E. S�.l(�t1:C—Ssl�r� <br />SYsT�v�n tN�r� �EANG6 I-IoOD C,���rccNr`y GDJt=12.�t7 8y �l�i��2 <br />SyS�ivt . <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kdchen sink 8 disposal <br />Dishwaslier <br />! Clothes washer <br />I _ Waterheater <br />' Sink (servicelbadmoplelc ) <br />�, Backllow preventer <br />Urinal <br />Dnnkmg Fountain <br />Floor drain <br />Grease trap <br />i Roof drains <br />= oine� <br />NO. I TYPE OF FIXTURE OR ITEM <br />NG — au hantlling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas freplace <br />Gas range <br />Clothes dryer <br />_ Range hood �� <br />_ Exhaust fan � FI RE s�rFa� ss � o� <br />Heat pump -- <br />Unit heater <br />Boiler <br />Refrigeration . \ � .� <br />Woodslove � �� <br />Other L�� � � � C� <br />_ , ��'� ' �' <br />� ;. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />II hereby ceridy that I have read and examined this appiicalion and know the same lo be irue and correcL All provisions of laws and <br />urdinances governing this rype of work wtll be complied with whether specified herein or nol The graniing of a permit does not presume <br />Ito give aulhonty to violate or cancel the provision of any other state or local law regulating conslruction or the performance o( <br />��. cunstruction. That I am authorized by the avner ot this property to perfomi the work for which application is made and I comply wth the <br />State Contractors Law 18.27 RCW and 296 Z00 WAC. , <br />i t/ZoIU <br />��� <br />