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F ,�RMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetriva.org a�,� _ p C <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE AODRESS <br />LOT NO. <br />CONTRAC OR <br />M,�,c y �a� <br />CONTR. LICENSE k <br />USE OF BUILDING <br />A V C— <br />BLOCK <br />✓�b <br />���t� lj•N��/scN <br />, <br />WORK DESCRIPTION <br />�6S1 �) �� ��� <br />NO. I 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 />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />PARCEL TAX I.D. p <br />c s - o� <br />TRACT <br />'1DDRE55 CI' <br />,an 37,b' y <br />-rT„ � C ��:,�/� 9� <br />CONTACi FOR PERMI <br />� <br />,- - .�.� �. - <br />PHONE <br />ADDRESS CITY2IP PHONt <br />/-lt/�c+� 3,'t8� E v�.rh� I�J/I 9'd'��3 �l,Z�'� a39 SsoZ <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />Electric Gas Other <br />N0. I TYPE OP FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <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 />Refrigeretian <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceriti(y 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 �vork will be wmplied with whether specified herein or not. The granting of a permit does not presume <br />to give au �ty to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />constru ion. t I am auth �zed by the owner of this property to perform the work for which application is made and I comply with the <br />State ntr or Lalv 8��/� zse.zoo wAc. z j j,/ <br />� /� <br />