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l <br />t <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEkETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPIICATIONS ARE ACCEPTED FROM 6 AM 70 4 PM <br />� <br />LEG�L LOT NO. BLOCK <br />DESG. <br />OWNfiR . <br />,� /'i �' �l// �/�.�� <br />7ENANT NnAAE <br />'/, <br />USE <br />PARCEL TAX I.D, !1 <br />TRACT OR 9UBGMSION L <br />PERMIT <br />PHONE <br />��pq,�//>��j'�%�' .3d'/O /(O�f��/�/� ��J-/ <br />�a � a6 -�� <br />�/ <br />N <br />�/c -0�03 <br />HEAT SOURGE I CONTRACT PRICE OF WORK <br />,� Electric � Gas _ Otner -� uG�� � f n� <br />WORK DESCR�PTION Ct%.P �O/'D�O.I@ �6 %/lf�r2// /.� S.sClI/ /S�.Efi j!��!/7IPS!'J <br />(//�c�o0/' ��� OCL�O�Oo/' G�/�/'�/ <br />NO. I IYPE OF FI%TURE OR ITEM <br />Tcilet <br />BalhtuU <br />Lavatory (Wash basin) <br />� Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />� Clothes washer <br />� Water haatet <br />Sink (service/bar/mop/ett.) - <br />Backtlow preventer <br />Urinal <br />Drinking Founlain <br />Finor draln <br />Gmese trap <br />^ Roofdrains <br />^ Other <br />NO. I TYVE OF FI%TURE OR ITEM <br />NC — air handiing unNs <br />Forced air systems . <br />Gas piping <br />Wafer heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hootl <br />Exhausttan <br />Heat pump <br />Unit healef <br />8oiler <br />Refrigerutian <br />Woodstove <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I heneby certity that I have read end axamined this appliCafion and know the same to be hub and correG. All provieions o( laws and <br />ordinences governing this type of work will be complied with whether specified herein or not. The grenting of a permit does not presume <br />to give aulhority to violate or cancsl the provision of any other stale or local law regulating construction or �he perfortnance o( <br />constniclion. That I am authorized by lhe owne� of this propehy to perfortn llle wark for whlch application is made and I compiy with the <br />state Con){actors �aw 1527 RCW snd 296.200 WAC. <br />