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/ � ;,'� I <br />SITE ADDRESS <br />LOT N0. <br />DESC. <br />ul;tU� l i <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRCET, 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 />BLOCK <br />CONTR. LICENSE p D(JJr.C�--� <br />USE OF BUILDING <br />■1 <br />PARCEL TAX I.D. It <br />TRACT OR SUBDIVISION # <br />C NTACT FOR`PERMIT <br />� Yl � �( (�t L� <br />HEATSOURCE <br />Electric Gas Other <br />WORK DESCRIPTION �' . � <br />�'/J ✓� i� C�lh%� � r `f j,1 ( , �� . �Oc���� �/ i � I <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toile� <br />BalhWb <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/e1cJ <br />BackOow prevenler <br />Urinal <br />Drinking Founlain <br />Floor druin <br />Grease irap <br />Roof dra�ns <br />Other <br />tb ��-�� <br />� jO��v GY3 <br />��PE(tMIT # <br />w6 I o �o - oo/ <br />7� <br />CONTRACT PRICE OF WORK <br />N0. I TYPE OP FI%TURE OR ITEM <br />A/C — air handling units <br />forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />qothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERErf LOCAL SALES TAX CODE IS 31U5 <br />I hereby cerlif�� that I have rcad and examined Ihis application ard know �he same to be irue and correct. All provisions of laws and <br />ordinances governing ihis type cf work will be complied with whe:her specified herein or noL The granting of a pertnit does not presume <br />to give 3uthority to violale or cancel Ihe provision of any other slate or local law regulating construction or the performance of <br />construction. Tliat I am autliorized by the owner of this property lo perfonn the work forwhich apptication is made and I comply with the <br />State Contrac�ors Law 18.27 RCW and 296.200 WAC. <br />/ � <br />� � i � <br />,� <br />%:�- �L��� ' /� ;�i_: ll-- `/ i )!�, /� <br />�/ <br />Z <br />