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PL�MIT APPLICATI� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FA.`� 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />L0T N0. <br />BLOCK I TRACT <br />PARCEL TAX I.D. # <br />I_;:r7rAIZ hc,/RFn//$L� <br />TENANTNAME I CONTACTFORPERMIT PHONE <br />CONTRACTOR tt=�( /Fn���v�,�:.I ADDRE55 �/4b Sd /,�J CITY2IP PHONE <br />chl�rc� r�.r or*ai��Al7 �3lw��t7/YSS'b <br />CONTR. LICENSE # �p� ��'� � ���x� <br />USE OF BUILDING <br />WORK DESCRIP710N <br />NO. I TYPE OF FIXTURE OR ITEM <br />� Toilet <br />2 BathWb <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 />Drin4ing Fountain <br />Fioor drain <br />Greasetrap <br />Roof tlrains <br />� Other il �i�.l /T <br />���7� <br />HEATSOURCE <br />Electric Gas Other <br />CONTRACT PRICE OF WORK <br />NO. I 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 />Ciothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refngeration <br />Woodstove <br />CITV OF EVERETT IOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of �aws and <br />ordinaces governing this rype of work will be complied with whether specified herein or not The granting of a permit does not presume <br />ro give authonty tc violate or cancel the orovision of arry other state or local law regulating construction or the perfortnance of <br />construction. That I am authorized by the owner of this property io perform the work for which application is made and 1 comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. i _ <br />