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,- <br />PE:��MIT APPLIC��'IG�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETr, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE P.DDRESS <br />lvg�l <br />LEGAL LOT N0. <br />DESC. <br />OWNER <br />j-el��7C. l�. - <br />TENANTNAME <br />CONTRACTOR <br />CONTR. LICENSE # <br />qty �fltJt �E <br />BLOCK TRACT <br />U lnJ 1�� e �L <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />lDqll at'= I�riut <br />CONTACT FOR PERMIT <br />AODRESS <br />HEATSOURCE <br />Electric _ Gas _ Other <br />WORK DESCRIPTION , <br />�.-,tSkatle-_{tv`1 d;- �a.; ����1..c.� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposaf <br />Dishwasher <br />Clothes washer <br />Laundry tray <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 />NO. <br />PERMIT # <br />SE Eve�-rt- l,�,Uk �( if ZU� <br />PHONE <br />�Z�i �%3�'tl�� <br />CITY2IP PHONE <br />I CONTRACT PRICE OF WORK <br />'�j�20� <br />��� � ��� <br />MECHANICAL <br />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 />Cbthe^, dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES SAX CODE IS 5105 <br />I hereby ceritify that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br />ordinaces 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 authonty to violale or cancel the provision of any other state or local law regulaling construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which aFplication is made and I comply with the <br />State�oHEraFtors Law 18.27 RCW and 296.200 b'JAC. <br />