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SITE ADDRESS <br />�nkN . <br />LOT NO. <br />DESC. <br />PCRMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��J <br />BLOCK TRACT <br />PARCEL TAX I.D. # <br />?Cn i .."l/�l�<'T <br />FOR PERMIT <br />CONTRACTOR �.�- j �\ e��i 1.� q ADDRESS j�� <br />i <br />CONTR. UCENSE #� S N C= � C'�T I`I� 5 u <br />USE OF BUILDING <br />WORK DESCRIPTI N <br />..l- �1 S�c.��A '� d •I� <br />W ��� �uL� <br />PERMIT # <br />-�_ <br />PFiONE f /� S-_- <br />� �7�7-7a' <br />PHONE <br />�}���� S�cirnzir PHONE <br />V��Arrt;e 3Cno �]�r�-I- <br />HEATSOURCE <br />i�Electric _ Gas _ Other <br />C(1NTRACT PRICE OF WORK <br />� <br />U�s Ca VS�' \,J F-��(�.-t �U.�(v�+J Ft ��-.�.n� S\�5�+2�b1 <br />��oc\� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />SinK (service/bar/mop/etc.) <br />Backilow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Ranc�e hood <br />Exhausl tan <br />Heat pump <br />Unit heater <br />Boiler <br />Reirigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know lhe same lo be lrue and cortect. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granling of a pertnit does nol presume <br />lo give aulhority to violale or cancel lhe provision of any olher stale or local law reguiating wnstruction or the peAortnance of <br />construclion. That I am aulhorized by lhe owner of this properly to peAorm the work for which application is made and I comply with the <br />State Co2Fractors'Cal�.r18.-27-fjCW and 296.200 WAC. <br />