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SITE ADDRESS , <br />����� <br />LEGA LOT NO. <br />DESC. <br />PERMIT APPLICATION <br />CITY OF EVERETT FERMIT 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 AN. TO 4 PM <br />7� f % <br />f/c�Uii��� <br />; �LOCK <br />PARCEL TAX I.D. # <br />�'~D�tr'- D U U- LJ d..'! <br />TRACT OR SUBDIVISION k <br />✓ .fln 7 �E r�� y f�l.�c ��f'� <br />PERMIT # <br />�,�'��SG3. /Il�% <br />TENANT NAME CONTACT FOR PERMIT PHONE �.� <br />"q � / �2'-r roa'. 6 % `%b <br />�r7��E .D� ��CFi E-MAIL <br />CONTRACTOR ADORESS CITY/ZIP PHONE <br />Fv��E`FTi f�:��/i��c' �i'.�i/����T� <br />CONTR. LICENSE # <br />USE OF BUILDING <br />���� <br />HEAT S RCE CONTRACT PRICE OF WORK <br />Electric _ Gas _ Other ���Ll� Cm <br />WORK DESCRIPTION <br />�''��i/'��raG�l F,�i�7ir���' ,��s�pE-�cF- <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilei <br />Bath�ub <br />Lavatory (wash basir) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e�c.) <br />Backflo�v preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />N0. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined lhis application and know the same lo be true and correct. All provisions of laws and <br />ordinances governing ihis type of work will be complied with whether specifed herein or not. The granting of a permit does not presume <br />te give authorily lo violate or cancel the prevision of any other state or local law reguiating wnstruction or the performance of <br />iconslruciion. That I am authorized by the owner of this property lo perform the work for which application is made and I comply with the <br />Slale C ra ors Lav� 1827 RCW and 296200 WAC. <br />I ��i� �1� o\ <br />