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PLRMIT APPLICATIGA <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org �3 0 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS -3701- Wry , o PARCEL TAX I.D. # PERMIT # <br />k(0 7-"i r�0y3at-1(0-10-5100 <br />LEGAL LOT NO. BLOCK TRACT 1,L1L n �rr �/1 �^t <br />DESC. 1 Z v2.(21r nJ C4 6u'.- lb-1 1✓—C7(D <br />OWNERADD/�/R�ESS CITYIZIP1 PHONE <br />^ 11 <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />Ak -�5o�r- (�, 0 <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING HEAT SOURCE jCONZTRA.CTPR10E OF WORK <br />Electric Gas Other — <br />WORK DESCRIPTION <br />PLUMBING Mtl F1ANIL""L <br />NO. I TYPE OF FIXTURE OR ITEM NO. I 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/bar/mop/etc.) <br />Backfiow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />_ Grease trap <br />_ Roof drains <br />Other <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 />Woodstove J <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions cf laws and <br />ordinates 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 stale or local law regulating construction or the performance of <br />construction. That I am authorized by the owner -of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and,,2 200 WAC. <br />