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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 />SITE ADDRESS PARCEL TAX I.D. # PERMIT # <br />jDE <br />L LOT N0• LBLOCK TRACT OR SUBDIVISION # <br />.R ADDRESS CITY/ZIPC'2�� Gi L( �7 C I Wyen ku t ?i_\ 'M �25 -�y3 `/OS <br />TENANT NAME ONTACT FOR PERM ITT PHONE <br />L12.S-`��y3 9oss— <br />CONTRAC70R ADDRESS �-- E-MAIL Tl-ha/1 7 J sn.c <br />CITY/ZIP PHONE <br />CONTR. LICENSE # <br />USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />G.0n�r\.g <br />arr\ 0'�Qd <br />NO. I 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 heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />Electric —Gas _ Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslen a <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 />_ Woodslove <br />Other <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 provisions of laws and 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 />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 oa ors La v 18Z7-R and 296.200 WAC. <br />