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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.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />ICI� '"1 <br />LEGA� LOTNO. I BLOCK <br />DESC. '�\ J-C�<_ <br />PARCEL TAX I.D. • <br />TRACTOR SUBDIVISION � <br />_ 3 "' <br />PERMIT K <br />'����ll —L'C� <br />TENANTNAME CONTACTFORPERMIT PMONE <br />EaAAIL <br />I <br />��.��� f,lilZrc'� 1" �ti L�ti<\. l�ja77�%I;xsi,1-;)L 1t=.i'i II�vI�Kvri ��'��.0 ?�j�(,�� <br />CONTR. LICENSE �I - � <br />USE OF BUILDING <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Cblhes washer <br />Water heater <br />Sink (service/badmopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Other <br />HEATSOURCE <br />Electric �, Gas _ Other <br />NO. <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unih; <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby certiry that I have read and examined this appliwtion and know the aame to be true and correcL All provisions cf laws and <br />ordinances goveming ihis type of work wBl be complied with whether specifed herein or noL The grenting of a pertnit does not presume <br />to give authoriry to violate or cancel the provision of any other state or local law regulating construction or the performant� of <br />construction.,That I am authorized by the owner of this property lo perfortn lhe work for which application is made and � comply with the <br />State Contr/8clors Law 1827 RCW a�d_296.200 WAC. <br />/1 l�I./.�� nr�.� � ;��{•1'i.�� <br />