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PtRMIT 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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TENANTNAME <br />CONTRACTOR �7�� <br />CONTACTFORPERMIT <br />�C.1 SS I <br />PHONE <br />�ss a s33 <br />SVc-�� i�CRE5S3OS o��FiS�� CITY2IP P ONE <br />7" 13��-rc �/ Q��Z� <br />CONTR. LICENSE N �/�{1�_�' � - - - <br />�.<<�� <br />USE OF BJILDING <br />WORK DESCRIPTION <br />UIvC �/ <br />HEATSOURCE <br />_ Electric _ Gas _ Olher <br />-�c.� o F� �� li1/s �!% <br />�S�M►�L+ � M�I �.,� I� - <br />NO. � 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 />Water heater <br />_ Sink (servicePoar/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 />/3. 28� . � <br />o� O c�� ���. <br />NO. � TVPE OF FIXTURE OR ITEM <br />wc - atr handiing units <br />Forced air systems <br />Gas pipi�g <br />Water heater <br />Gas Tirep�ace <br />Gas range <br />Ciothes dryer <br />Range hood <br />Exhaustfan <br />Healpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCA� SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this application and know ilie same to be true and correct. Ail provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or nnt. The granting of a permit does nol presumo <br />to give authority to violate or cancel the provision of any other state or locai law rogulaling construction or the per(ormance of <br />conslruclion. That I am aulhorized by lhe owner of this property to perform the work tor which application is made and I comply wilh the <br />State Co�itractoSs L�b.27 RCW and 296200 WAC. <br />