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SITE ADDRESS <br />CG71 <br />DESC. <br />CONTRAC OR <br />CONTR. LI NSE N � �� <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PERMIT APPLICATION <br />CITY OF €�'ERETT PERMIT SERVICES <br />3200 CEDAR S1�REET, EVERETT, WA 98201 <br />425-257-8t�1C - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. N <br />� OLOCK TRACT <br />ADDRESS CITY2IP <br />� ��3r. :�:f � � ��.�v/� I�/ 5 <br />CONTACT FOR PERMIT <br />ADDRE55 CITYIZIP <br />����J T � <br />`il ��� <br />NEATSOURCE I <br />�Electric _ Gas _ Other <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 />Clotl�es washer <br />Laundry tray <br />`iink (servicelbadmoplelc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher _— - <br />9-/a-o <br />PHONE <br />PHONE <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/G – air hantlling units <br />Forced e�r systems <br />Gas pipr�g <br />� Water heater <br />Gas fireplace <br />Gas range <br />� Clolhes dryer <br />Rangehood <br />Exhaust fan <br />Healpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX COOE IS J705 <br />I hereby ceritily Ihat I have read and examined this application and know the same to be true and correcL All provisions of laws and <br />ordinaces goveming Ihis 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 vielate or cancel �he provision of any uther stale or local law regulating construclion or Ihe performance of <br />conslr� . hat I am authorized by the owner of this property to pertorm the work for which application is made and I comply with the <br />State onl r� Law 18.�'f RCW dnd 296200 WAC. / j <br />