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SITE ADDRESS <br />5oz7-2%1�, <br />LEGA LOT NO. <br />PERMIT 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 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />VV �� <br />BLOCK TRACT OR SUBDIVISION # <br />PERMIT # <br />fj��rl�oir GllcsTin'-6f��as <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />E-MAIL <br />-6569 <br />CONTR. LICENSE # /a25-J PA <br />USE OF BUILDING i ' l l I HEAT SOURCE I CONTRACT PRICE OF WORK <br />_ Electric _ Gas _ Other <br />WORK DESCRIPTION �� Jor�_Sf�fl /t�s SriiLL �p/111�03/ i /oN <br />�jF'E2aod� <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. 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 />Water healer <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other. <br />_ <br />— <br />— <br />— <br />_ <br />— <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />— <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 />Range hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />ove <br />Other <br />-- — <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisi-ns of laws and <br />ordinances 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 authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />c suction: Thal I am agttlhorized by the owner of this propert o perform the work for which application ,s made and I comply with the <br />��olov ol`rM �..� 9QF 9nn WAC. <br />6 <br />re <br />