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..w <br />w. <br />—.o.:. zero UF{ <br />P�r�MIT APPLICATIOrI <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 <br />SITE ADDRESS PARCEL TAX I.D. # I <br />h <br />G0�/ alr <br />LEGAL LOT NO. BLOCK TRACTOR SUBDIVISION # <br />DESC. <br />OWN ADDRESS CITY/ZIP <br />I CONTACT FOR PERMIT PHONE <br />E-MAIL <br />�NTRACTUR ADDRESS ITVIZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric '/Gas Other <br />WORK DESCRIPTION S.� <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. NO. TYPE OF FIXTURE OR ITEM <br />. Toilet A/C -air handling units <br />Bathtub � Forced air systems <br />1 Lavatory (wash basin)zL Gas piping <br />)_f, Shower � Water heater <br />/ Kitchen sink 8 disposal _Gas fireplace <br />-'7 Dishwasher Gas range <br />/ Clothes washer —% Clothes dryer <br />Water healer � Range hood <br />_ Sink (servicelbarlmoplelc.) Exhaust fan <br />_ BackBow preventer Heal pump <br />_ Urinal Unit heater <br />_ Drinking Fountain Boiler <br />_ Floor drain Refrigeration <br />_ Grease trap Woodstove <br />_ Roof drains _Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />I hereby 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 permit does not presume <br />to give authority to violate or cancel the provision of any other stale or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Stale Contractors aw 18.2,1 RCW and 296.200 WAC. <br />/,rjf// !r <br />Signature of Owner/Contractor/Authorized Agent Date <br />PERMIT APPLICATION <br />APPLICATIONS <br />14 <br />I.D. <br />FERMI <br />PHONE <br />1%//,��, 1-� Cap-/ Lvi�/ � %2r- <br />TENANT NAME <br />PERMIT APPLICATION <br />APPLICATIONS <br />14 <br />I.D. <br />FERMI <br />PHONE <br />1%//,��, 1-� Cap-/ Lvi�/ � %2r- <br />TENANT NAME <br />