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P�RM6T APPLICA�'IG�J <br />CITY OF EVERETT PERMIT SERVIGES o�-� <br />3200 CEDAR STREET, �VERETT, WA 98201 �%'�7` <br />425-257-8810 — FAX 425-257-8357 — www.everettwa.org G G SG�� _� Z 3 <br />i� <br />AF'PLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CAP,DS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # P RhiIT K ,� <br />�=4 I I � E.� �� I �-r � S-'��-�� �_ <br />LEGAL LOTNO. BLOCK TRACT <br />' ��21� � C�'PI-1 L-� Gt_SD iJ <br />TENANT NAME <br />CONTRACTUR i I�'���('/-��,�'�J�l_ <br />CONTR. LICENSE # <br />USE OF BUILDING <br />I-'�":;�1>I_ i`,i(-(=_ <br />WORK DESCRIPTION <br />�7 �f I I (�' I� I� i- <br />CONTACT FOR PERMIT <br />ADDRESS <br />il ii <br />HEATSOURCE <br />Eleclric �\Gas _ Other <br />GV«�rr ���,201 (4zs)zsz <br />PHONE <br />CITYIZIP PHONE ` <br />;� �i <br />CONTRACT PRICE OF WORK <br />/ ;iL:'� i <br />I�( �/Y� CC�`� . �>j J� /� �'�Y.r, �I - �V (,l.'Li L<; � � jl �)c. �-,r ;�,-e',._j <br />J� <br />NO. I TYP� OF F�XTURE OR ITEM <br />� <br />� _ <br />� <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink fservice/bar/mop/etc.) <br />Back(low preventer <br />Urinal <br />DrinkinQ Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />A1C - air handling uniis <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 />Heatpump <br />Unit heater <br />Boiler <br />Re(rigeration <br />Woodslove <br />Otner <br />CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br />I hereby ceriti(y lhat I have read and exami�ed this application and F now the same to be irue and correcL All provisions of laws and <br />ordinaces goveming this type of work will be complied with whether.:pecified horein or noL The granling of a permit does not presume <br />to c�ive authority lo �io!ate or cancel the provision of any other slate or �oral law regulating censtruction or the performance cf <br />construclion. That I am authorized by lhe ovmer of this property lo perfor.n lho work for which applicalion is made and I comply N�ith the <br />State Coptraclors l.aw 1&27 RCW and 296.200 WAC. <br />i` <br />, . 1�,._ �f;' Z 7 / � ^S <br />� <br />