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I <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 —FAX 425-257-8857 — vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />SITE ADDRESS I PARCEL TAX I.D. t{ <br />PERMIT # <br />W t,All.' <br />CCJ808'-u"� <br />LEGA LOT NO. <br />BLOCK <br />TRACTOR SUBDIVISION N <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />E-MAIL <br />—L�6ATk�CCTaF A15DRESS I <br />CONTR. LICENSE N <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />P, , <br />_Electric _Gas _Other <br />WORK DESCRIPTION <br />L t C< �� t c 't <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTI!kE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C —air handling units <br />_ _ <br />Bathtub <br />Forced air systems <br />_ _ <br />_ <br />Lavatory (wash basirj <br />Gas piping <br />Shcwer <br />Water heater <br />_ <br />_ <br />Kilcnci. sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />_ <br />_ <br />Sink (service/barhnop/etc.) <br />Exhaust fan <br />_ <br />Oackflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />TAX <br />CITY OF EVERETT LOCAL SALES <br />CODE IS 3105 <br />I hereby cerilily 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 state or local law regulating construction or the performance of <br />construction.-Tha mauthonzel by the owner of this property to pcdorm the work for which application is made and I comply with the <br />Stal-Contraclo � 113.27�RCW and 290.200 WAC. <br />of ¢'caner/C a i uthorized Agent Date <br />i <br />s <br />