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SITE ADDRESS <br />G� ��,^ <br />LEGAL LOT NO. <br />TENANTNAME <br />CONTR. LICENSE M <br />USE OF BUILDING <br />WORK DESCRIPTION <br />F`RMIT APPLICATIt�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 />PARCEL TAX I.D. fi <br />BLOCK I TRACT OR SUB�IYISION # <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />BxL(low preventer <br />Urinai <br />Drinking Founlain <br />Floor drain <br />Grease trep <br />Roof drains <br />OtherRrnlr�ca �..c..lti.� <br />--� <br />� �na ��K• 7z�� <br />CONTACT FOR PERMIT <br />HEATSOURCE <br />Electric Gas 01her <br />PERMIT A <br />PHONE �rj� �� y <br />CONTRACT PRICE OF WORK <br />NO. I NPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />N'ater heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust (an <br />Heat pump <br />Unil heater <br />Boiler <br />Retrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that 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 rype of work will be complied with whether specified herein or nol The granling o( a permit does not presume <br />to give authonty to violate or cancel the provision of any olher state or local law regulating consWclion or lhe performance ot <br />construclion. That I am authorized by thr. owner of this property to per(orm the work for which application is made and � comply wilh the <br />Sta�e Coniractors Law 18.27 RCW and 29L.200 WAC. <br />