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S�TE ADDRESS <br />�-rRMIT APPLICATI.�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8610 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D.1t <br />LOT NO. ( BLOCK I TRACT OR SUBDIVISION # <br />a-�7--/v <br />PERMIT # <br />b=1�,sc 7�f <br />TENANTNAME <br />CONTACT FOR PERMIT <br />PHONE <br />.� •' ���• - '�` <br />CONTR. UCENSE U <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />Eleciric Gas Other <br />WORK DESCRIPTION � <br />� ��f.-v-.,. � .�i`�.�,`r'". �. v��C— <br />`' ;%�,�.a'.�.�.�1..-�-'�f ✓h��»u�-v�_ <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />water healer <br />Sink (service/badmop/etc.) <br />Dackflow preven�er <br />Urinal <br />Drinking Pountain <br />Floor dram <br />Grease Irap <br />Roof drains <br />Olher <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />NC — air handling uni�s <br />Force9 air syslems <br />Gas piping <br />Water heater <br />Gas 6replace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhausl fan <br />Heatpump <br />Unit heater <br />Boiler <br />Refngeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SAIES TAX CODE IS 7105 <br />I hereby certify Ihat I have read and examined Ihis application and know lhe same to be Irue and correcL All provisions of laws and <br />ordinances goveming this type oi woik will be complied with whether specdied herein or not. The granling o1 a permA does not presume <br />to give auQiority to violale or cancel Ihe provision of any other state or Iocai �aw regulating consiructio� or the peAormance of <br />consiruction. That I am authorized by ihe owner of this propeAy to perform ihe work lor which application is made and I comply with the <br />Slate ConUactors Law 1827 RCW and 29620D WAC. <br />v�a <br />