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i- cRMIT APPLICATION <br />ClTY 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 />SITE ADDRESS � PARCEL TAX I.D. # <br />. .'/ .-�-/ '�'�.' I � L �. <br />LEGAL LOT NO. <br />DESC <br />i _ <br />OWNER <br />, <br />+,' � ' .% <br />TENANTNAME <br />CONTRACTOF ' <br />j�i�,; <br />CONTR. LICENSE # <br />USE OF BUILDING <br />TRACT OR SUBDIVISION N <br />?�'T�� :�'� -; <br />CONTACT <br />PERMIT iF <br />- �`;.,.,�„�— /�'l�rs,i,� yy>"�5i�""s <br />�, <br />PERMIT PHONE <br />XUURC.7J `�" "'-' <br />i � <br />-� , r:,i'. ,r, ,.../;.• !.. . i <br />C^��`I.,,i��,l �,�_ r��� ��.. <br />WORK DESCRIPTION <br />� , , ,;, _ j . l , , <br />�, <i�,�. <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ Toilel <br />Dalhtub <br />Lavatory (wash basin) <br />Shawer <br />Kitchen sink & disposal <br />Dishwasher . <br />Clolhes washer <br />Water heater <br />Sink (service/badmoplelc.) <br />Bachfiow oreventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease irap <br />Roof drains <br />Other <br />— HEAT SOURCE I CONTRACT PRICE OF WOFK <br />Electric _ Gas _ Other�� �1. j(�i cJ <br />� ; , � ... <br />( � �-, f ( �; .: .�� ti i <br />MECHANICAL <br />INO. i TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exliaus� (an <br />Heal pump <br />Unit heater <br />�oiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certiry that I have read and examined ihis applicalion and know the same to be irue and correcL Ail provisions of laws and <br />ordinances goveming this type of work will be complied with whelher specifed herein or not. The granting of a permit does not presume <br />�o give authority to violate or cancel the provision of any other slale or local law regulating consiruction or �he peAormance of <br />conslruction. That I am authorized by the owner of this property to pertorm ihe work for which application is made and I comply with the <br />State Conlradors Law 1827 RCW and 296200 WAC. <br />�— .� '" �( f � � ( C` <br />= , _ , . ' ( -� ...— .— <br />