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PEaM1T �APPLICATION <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� ���D <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�ITE ADpRESS <br />� ) ��" �- � � '� 'Q� <br />LEGAL LOT NO. BLOCK <br />DESC. <br />OWNER <br />C17v��,1c1�Ivr;M ��'.t(�(;c� <br />TENANTNAME I <br />NTRA TOR <br />i'� �,� r' fu�t c!-%ci trn; � Gi?3, �,�. <br />CONTR. LICENSE • <br />USE OF BUILDING <br />. . _ „ , <br />WORK DESCRIPTION " <br />l! . � ' i, "" '.I.' <br />LUMBI G <br />NO. I TVPE OF FIXTURE OR ITEM <br />Toilet <br />_ Bathtub <br />Lavalory (wa,h basinl <br />Shower <br />Kitchen sirk 8 disposal <br />Dishwasher <br />Cbthes washer <br />Water heater <br />Sink !serncelbadmop/etc.) <br />Bac!<Flow preventer <br />Unnal <br />Drinking Foun�ain <br />�loor drain <br />Grease trap <br />Roof drains <br />Other <br />PARCEL TAX 7.D. # <br />TRACT OR SUBOIVISION � <br />,�� <br />CONTACT FOR PERMIT <br />3 ���� i��icf`-;��_��z- <br />/�Gti' -/ , <br />HEATSOURCE <br />'� Eledric Gas Other <br />PERMI7 # <br />�DD%%L� � C�O d- <br />PHON�� 5� <br />�. /1" ��J <br />ZU4' .��t/ ' ��u <br />� <br />�, a•°7[:�t- <br />P ' ���� <br />3G�v (r) _� -t�x;� <br />;, u�a���� <br />iI�ACT PRICE OF WORK <br />10.8 75 .`v _ � <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />_ Forcedairsystems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />'Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be tme and cortecL All provisions of laws and <br />ordinances goveming this type of work will be complied with whether specified herein or not. The grenting o( a pertnit does not presume <br />to give authonry lo violate or cancel the provision of any other state or local law regulating construclion or the performance of <br />construction. Thal I am authorized by the owner of this property to pericrm the work for which application is made and I comply wilh the <br />Slate CoptractQrs Law 1827 RCW and 296200 WAC. <br />