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P�r�M�T APPLICATIO�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 -- FAX 425-257-8857 — www.everettwa.org � `�6 � <br />APPLICATIONS ARE ACCFPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />CONTRACTOR <br />/y:7�6 ,/.;�_.',�'u6;-•',;, r, T <br />CONTR. LICENSE # , , <br />USE OF BUILDING <br />WORK DESCRIPTION � � <br /><rf'��,�r�li <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />IPARCEL TAX I.D. # <br />003�'(,SUODO />a� <br />TRACT <br />� So''—" s�, �v�'� L1T/ 9�'2v3 5'1r-,2 s�- i� <br />CONTACTFORPERMIT � PHONE <br />lS,v Ho�s� YLs'- ��6->i 39 <br />ADDRESS CITY2IP PHONE <br />� `P2'L/oi�i�� .'�i.rH!J/lce� iu��fl�;� 3�633-5 <br />CONTRACT PRICE OF WORK <br />� ,�r, 7;�/,.�i,✓G aJ¢LG�.sLe,�.,J�—�e.E�r- <br />wc — air nananng unics <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigera!ion <br />Woodslove <br />Other <br />I hereby ceritify that I have read and examined this applicalion and know the same to be true and cortect. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give aulhority to violate or cancel lhe provision of any other state or local law regulating construction or the performance of <br />construction T}�t I a�p'�uthorized by lhe owner of this property lo perfortn the work for which application is made and I comply with the <br />State Contr�tpr$taGv 58.27 RCW and 296200 WAC. ,, , <br />