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a <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 />SI fE ADDRESS �^ <br />PARCEL TAX I.D. # PERMIT# <br />LEGALL LOT NO BLOCK IRACTORSUBCIVISION# I D ���7-� <br />DESC.( <br />/� a.vnc'a CITYr?IP <br />��A Ir A"{ (.dl �l RO(�FPT✓CS C ilS p PHONE <br />IE�NA�N�T ?1lAM�LEJ� �,�_�,/n O07 P" �p <br />I CONTACT FOR PERMIT <br />PHONE <br />NTRA T R <br />CONTR. LICENSE # <br />USE OF BUILDING <br />WORK DESCRIPTION <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />_ Electric — Gas Other <br />De,"o 1e oU3F d �av� <br />N0. TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Finer drain <br />Grease trap <br />Roof drains <br />Other <br />No' I TYPE OF FIXTURE OR ITEM <br />IAJC — 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 heater <br />Boiler <br />Refrigeration <br />W^odstove <br />Olner <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be :omplied 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 />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 Co� ctors 18.27 R Wand 296.200 WAC. <br />