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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PERMIT If <br />H:3-0`iSF.AHUF-57FAOF- FJJl&ZE %-Zo3 DUs"05 8OL70pa.3C)O Z <br />LEGA LOT NO. BLOCK TRACT <br />DESC. <br />OWNER ADDRESS CITYMP PHONE <br />KE1J.IAJ MCKAS' `-/S-09 5F11Ha&YFAL)E JLF7T98.�Ds 5'd5. 3�3-f' <br />TENANTNAME CONTACT FOR PERMIT PHONE <br />CONTRACTOR ADDRESS CITYMP PHONE <br />HOA/lF FIZOIJT -TIJC-. 7307UffFR Pzb6E Kt,. EUIF/Z-'T-% 982C3 <br />CONTR. LICENSED 1-404A FS* 777'Pl.= <br />PARCEL TAX I.D. If <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />W-Z:ZDFk)t!-E I. _ Electric _ Gas _Other I y ; {�) - <br />WORK DESCRIPTION <br />E-kTEAJ,D Exi .fit ZUC 65:.kTEIL709- -br cAt- <br />NO. I TYPE OF FIXTURE OR ITEM I NO. <br />Bathtub I =- <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 />Backfiow preventer <br />Urinal -- <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />�11k-2 Z <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE 1S 3105 <br />I hereby cerilify that I have read and examined this application and know the same to be true and corect. 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 ether state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with fhe <br />State Contractors Law 18.27 RCVy6%rW,296.200 WAC. <br />