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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 - wnvvv.eveiettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. A t'E IT p <br />i off /I 7'= <br />UEGAfl LOT NO. BLOCK TRACT/ <br />DESC. `.J Bro4c'r_1' , r"_Ae.vN♦ <br />Jca C L C YYl("� CL< 1 LI ak Ilk,!, sc ,I,; •:;:5:5 - 3I�f� <br />TENANT NAME 1 CONTACT FOR PERMIT PHONE <br />CONTRACTOR <br />CONTR. LICENSE <br />ADDRESS <br />USE OF BUILDING (i HEAT SOURCE <br />ttCc � h V L) _ Electric —Gas _ Other <br />CITYIZIP PHONE <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />ex3 cook <br />reM�ul NJn . �oGcl i�egr r1i („1 , <br />A%' J <br />PLUM13ING A' r MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXTURE OR ITEM <br />_ Toilet <br />_ Bathtub <br />_ Lavatory (wash basin) <br />_ Shower <br />_ "Chen sink & disposal <br />_ Dishwasher <br />_ Clothes washer <br />_ Laundry tray <br />_ Sink (service/bar/mopfetc.; <br />_ Backflow preventer <br />_ Urnal <br />_ Drinkirrj 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 heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />I hereby ceri8ty 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 compfied with whether specified herein or not. The granting of a permit does not presume <br />to give authority tc 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 />St ea 6�ontractrs Law 18.27 RCW &nd 296.200 WAC. <br />IInn 11 <br />I!L <br />