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PEaMIT APPLICATIOI� <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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />LOT NO. <br />DESC. <br />TRACT <br />PARCEL TAX I.D. # <br />PERMIT A <br />Moyo 7 <br />CONTRACTQR <br />��1,R.'P��sE��, / <br />�' �l <br />USE OF BUILDING <br />WORK DESCRIPTION <br />NO. <br />�' 1. /z C <br />ADDRESS <br />HEATSOURCE <br />Eleclric _ Gas _ Other <br />CITY2IP ?HONE <br />CONTRACT PRICE OF WORK <br />�'� �i � [ ��,' l�/ � %r�,-r, / d� /� d �l� -D 5� % <br />1'LU <br />TYPE OF FIXTURE OR ITEM <br />Tailet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX COOE IS 3105 <br />I he•eby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />to give aul to violate or cancel the provision of any olher state or local law regulating construction or the performanc� of <br />constru ion. That m aulhorized by the owner of this property to perform the work forwhich application is made and I comply with lhe <br />State C ntr L��W an� 6.200 WAC. �/ '/� <br />