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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 />SITE ADDRESS <br />LOT NO. <br />/ <br />NAME <br />�.vn i nn�. � vn <br />b u/✓� P v <br />CONTR. LICENSE p <br />USE OF BUILDING <br />� c{, � c c�P. <br />WORK �ESCRIPTION <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />, v� ooyd onn�ocs o6 <br />BLOCK TRACTORSUBDIVISI # <br />�-- C c, ,$ C c�. �E � eY► GC_ e <br />OGN��(�/ti t� <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />6alhlub <br />Lavatory (wash basin) <br />Shower <br />Ki�chen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/badmopletc.) <br />Backtlow prevenler <br />Urinal <br />Drinkinc� Fountain <br />floor drain <br />Greasetrap <br />Roof drains <br />Other <br />PERMIT # <br />)If[53 GIIT/ZIP YHunt l,w5- <br />/�/ r� �� <br />3� i.�/OOcXcr2WnA!/e /�/CvN� lg��� <br />CONTACT FOR PERMIT <br />PHONE <br />^�l <br />%S <br />AUDRES CITY/ZIP PHUnt <br />�'r 33 0��/��«,n .��e Euc�CTl r� g1�-3 91S•.��7-S/�� <br />HEAT SOURCE �ny� I CONTRACT PRICE OF WORK <br />Electric Gas Other <br />0 1 �Cc���-/'� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Reirigeretion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 7105 <br />1 hereby certify Ihat I have read and examined ihis application and know lhe same to be irue and correct. All provisions oi laws and <br />erdinances goveming ihis lype of work will be complied with whether specified herein or not. The granting of a permil does not presume <br />to give authority to violate or cancei Ihe provision of any ofher slate or local Iaw regulating construction or the perfortnance of <br />construction. Tliat I am aulhorized by the owner of this propeAy to perform the work for which applicalion is made and I comply with the <br />Stale Copiracto s law �B. 7 RC and 29�200 WAC. <br />„% '1l.!/°/jI �G1. � �'�� �v <br />