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SITE ADDRESS <br />DESC. <br />TENANT <br />COnTR. LICENSE p <br />USE OF BUILDING <br />� <br />WORK DESCRIPTION <br />PtRMIT APPLICATIUN <br />CITY Oi 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 />PARCEL TAX I.D. # <br />TRACT <br />CONTACT FOR PERMIT <br />PERMIT # <br />PHON <br />�: 5v3—v 3—��S <br />� C,S� -< -�-9'C�IT� <br />CITY2IP PHONE <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />Electric _Gas Other /y,� j�/y'�j C �� <br />�,� ���wct= r�f/_�r�i-�r���t�.�i 9�t; ='�C'!Fi��" �'�-a u �Y <br />Np, � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhlub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washcr <br />Water healer <br />Sink (service/bar/mop/elc.) <br />Back9ow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Root drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air;yslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrango <br />Clolhes dryer <br />Range hood <br />Exhauslfan <br />Heal pump <br />Unil healer <br />6uii�r <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions oi laws and <br />ordinaces goveming this type o( work will be complied with whelher specified herein or noL The granting of a permit does nol presume <br />lo give aulhorily lo vioiate or cancel Ihe provision o( any other state or local law regulaling constructicn or the performance of <br />conslruction. That I am authorized by Ihe owner of this property to periorm the work (or which applicalion is made and I comply with the <br />State Coniractors Law 18.,�7 RCW and 296.200 WAC. <br />�lL <br />