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PERMIT AP�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereriwa.org ��7L4��"_`_/ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE/A-DDRESS <br />U' <br />LEGA LOTNO� <br />DESC. <br />OWNER <br />Q�i 15Qr1 �I�l1�1 S ,1v�C <br />TENANTNAME <br />CONTRACTOR <br />IR��i Sank{pn�es Zv,c. <br />CONTR. UCEHSE � ' <br />ti4Ri z' <br />USE OF BUILDING <br />PARCEL TAX I.D. X <br />� �S � - - <br />BLOCK TRACT <br />5 A � i�u - r� <br />ADDRESS � — -�- <br />� o �a.� Evu9ree�.Wr +la5•�I73 <br />WORK DESCRIPTION <br />��� � i 3s �, <br />PLUMBING <br />N0. I TYPE OF FIXTUNE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Y.itchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drein <br />Grease Vap <br />Roof dreins <br />Other <br />HEATSOURCE <br />_ Electric ✓ Gas _ Other <br />L'C'1 <br />V <br />� <br />PHONE <br />'"`ld <br />�� ov.i -ti ia- (d"l�i I <br />CITY2IP PHONE <br />�vueit 4�2,0'( 4 dS•4 3�5-10 3 G5 <br />n <br />CONTRACT PRICE OF WORK <br />?rv`jet.-k '(�ar�e-; <br />�c.cldu Lane� <br />TYPE OF FIXTURE OR ITEM <br />I w� - air nanaung urnts <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Baiier <br />Rehigeration <br />Woodstove / <br />Other V <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 5705 <br />I hereby ceritify that i have read and examined this aopiication and know the same to be We and corted All provisions of laws and <br />ordinaces governine this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />;o give a�thonty to violate or cancei the provision of any other state or lowl law regulating :.onstruction or the perfortnance of <br />:onstruction. That I am authorized by the owner of this property to peRorm the work for which application is made and I comply with the <br />itate Contractors Law 18.27 RCW and 296.200 WAC. <br />Z <br />