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c <br />PtRMIT APPLICATIClN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettw2.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />33�a �vGK-er f�ve <br />A LOT NO. <br />c. 3 I <br />IER <br />5� 0.v� <br />4NT NAME <br />�s�,� � <br />CONTRACTOR t„\��� <br />CONTR. LICENSE # <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />�043� 5 � 8 � 031 0�7 <br />TRACT <br />PERMIT N <br />t'72(� \�err�on �1. �nK�-�evenS �(2S41b''S29 <br />WORK DESCRIPTION I� <br />a'e'��C-e— roo-Y <br />PLUMBING <br />NO. I NPE OF FIXTURE OR ITEM <br />Toilel <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwashcr <br />Clothes washer <br />Laundry tray <br />Sink (servi:e/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />CONTACT FOR PERMIT <br />�.,�„ h �3�, r �- <br />AODRESS <br />HEATSOURCE <br />_ Electric % Gas _ Olher <br />PHONE <br />�4Z5 yl � SZg�f <br />CITY2IP PHONE <br />I CONTRACT PRICE OF WORK <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handlinc� unils <br />Forced air systems <br />Gas pipin� <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiier <br />Refric�eration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE !S 3105 <br />I hereby ceritify lhat I have read and examined this application and know the same to be lrue and cortect. All provisions of laws and <br />ordinaces goveming this type of work will be complied with whelher speci(ied herein or noL The granling ot a permil does not presume <br />lo give authom to violate or cancel tho provision of any other stale or local law regulating construction or the pedormance of <br />constn on. TFj�I I am authorized by the owner of this property �o perform lhe work for v:hich applicalion is made and I comply with the <br />Slale ontrac�6Fs Law 18.27 nd 296.200 WAC. <br />(�/����" ���� 9���05 <br />