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PERMIT APPLICATI�N <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 <br />SITE <br />LOTNO. � BLOCK � TRACT <br />DESC. <br />PARCEL TAX I.D. p <br />TENANTNAME � I CONTACT <br />� <br />CONTRACTI._'R _ � i •�, \1 ��S -T-PDDRESS <br />� �x��li' v ..l%ic <br />USE OF BUILDING <br />WORK DESCRIPTION <br />��� <br />LUMBING <br />NO. I TYPE OF FIXTURE OR I7EM <br />Toiiet <br />Bathtub <br />avatory (wash <br />S wer <br />Kilc n sink 8 � <br />Wator <br />Sink h <br />ing Fountain <br />draln <br />so trap <br />drains <br />HEATSOURCE <br />ric _ Gas _ Other <br />CITY2IP <br />�a ��- ko � <br />�o�v9 �-��S <br />PER IT I% <br />70� i <br />NO, TYPE OF PIXTURE OR ITEM <br />C — air handling unils <br />rced air syslems <br />G piping <br />_ Wa rhoator <br />Gas i placo <br />Gas ra o <br />Clothes <br />Range ho <br />Exhaus an <br />Heal mp <br />Unit eater <br />CITY OF EVERETT LOCAL SALES TNC CODE IS J105 <br />I lioreby c ritify that I�vo raad and examined this applicalion and know the samo lo be true and correct. All provisions o( laws and <br />ordin verning t's typa ot work will bo complied with whether specified herein or not. The granting oi a pertnit does not presume <br />f give auth to viol o or cancel the provision of any other state or local law regulating canstruc�on ar the pedortnanca oi <br />construcf . l 1 am �ulhorized by tho ownar of this propeKy to pedorm lhe work for which application is made and I comply with lhe <br />State C tracl Law 1�27 RCW and 296.200 WAC. <br />S e o Owner/Conlr u ionze Agent late _O � <br />`(Z <br />