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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITF AUDRESS <br />�i // Z SJt�N>> i�-✓� <br />LGGAL LOTNO. I BLOCK <br />DGSC <br />� E-�/� P2�� �J�cN <br />TENANTNAME <br />CONiRACTOR <br />����/7/N�S[�� i �L/Y7 ��� /Ni� <br />PARCEL TAX I.D. 0 <br />TRAGT <br />CONTACT FOR PERMIT <br />ADDRESS CITYIZIP <br />.� 93 3c '/J- 4.>r Fl � � n,�t` <br />PERMIT K <br />PHONE <br />PMONE <br />jNu ��'s �YhL <br />CONTR. LICENSE il 7 <br />� vhiNj'�{ Z71 [ L �/� (-//vC./��N �7 f: 2 3 <br />USE OF BUILDING � HEAT SOURCE I CONTRACT PRICE OF WORK <br />S 1= � <br />WORK DESCRIPTION <br />/NS/�'�-LC /=//1� <br />I_ Electric _ Gas _ Other <br />S/'/'in.,i�cc`)LJ /N rJ�7.�, <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavatory (wash basm) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountaln <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />S Z ��Ti <br />J 'r �'. <br />NO. I NPE OF FI%TURE OR ITEM <br />NC — air handhng units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas freplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />Olher <br />�=I C! w�.��K c t-7E- FiC7i-riS <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I I hereby ceritdy that I have read and examined ihis application and know ttie same to be true and wrrect. All provisions of laws and <br />� ordinaces governing ihis type of �vork will be compl�ed with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating consiruction or the perfortnance of <br />'� construction That I am authorizeC by the o�ner o'th��s property lo perform the work for which application is maAe and I comply �vith the <br />�� State CoMractors Law 1827 RCW �nd 2962001NAC. <br />