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l <br />PERMIT APPLICATION <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 />, <br />� C� ,_, �� �!, ;� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM k p 7d5• GG � <br />SITE ADDRESS I PARCEL TAX I.D. N I PER�M7IT M / <br />-L.__�a w: .�`i.� . . .. n �1.� A.,L v /n' �.— - �o(p <br />DESC. <br />TENANT <br />LOTNO. I BLOCK I TRACT <br />Z41J �� �r, <br />CONTACT FOR PERMIT <br />CONTRACTORC6�Cv �I�E' fR-G'j�Cqlq.� ADDRE55`h�� ����JIILC �� {��1.�'� �' �� a'g60 <br />CONTR.LICENSEpC[7 jC'n�FP{1Ui.� � WCP��ItNN14LE) 17�A_ QgU�IZ <br />f_xC-I �-��-�4 �d2�itv8�•-G,�o <br />USE OF BUILDING <br />HEATSOURCE <br />_ Electnc _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION � <br />A-(%� l%�rJ� �L�I.�C.ATb nL. SPK�AIkI£-� L�%�� �ble Al�vJ WA-I�- <br />�AYvoT d'�( 5�u0 ��- a�' �'N���E�. K�OC� <br />NO. I NPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basm) <br />Shower <br />Kdchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry Vay <br />Sink (service/barlmop�etc ) <br />Backflow preventer <br />Urmal <br />Cnnking Fountain <br />Floor drain <br />Grease trap <br />Root drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />AiC - air handling u�ds <br />Forced air systems <br />Gas piping <br />Water neater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust (an <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT IOCAL SALES TAX COOE IS 3105 <br />I hereby cenUly thal I have read and exammetl this application and know the same to be :rue and correc� All provisions of laws and <br />ordinaces governing ih�s rype of work H�ill be complied wdh whether speci(ied herein or nol The granting of a permd does not presume <br />to give authonty to violale or cancel the provis!on of any other state or local law regulating construction or the pedormance of <br />con�tr(t�on. That I am authonzed by ihe owner of this property to pertortn the work for which applicalion is made and I comply with the <br />Sta(e Cwltractors Law 1827 RCW and 296'R00 WAC. . <br />