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PERI'►AIT A�PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425•257-8857 — vr �uv.everettwa.org <br />� <br />LOT i . <br />TENANTNAME <br />APPLICATIONS ARE ACCEFTED FROM 6 AM TO, PM <br />I•l1:Td��IZ�l1�lf; <br />BLOCK I TRACT OR 8UBDIVISION M <br />II �� ul lJ <br />CONTACT FOR PERMIT <br />u � TU. r�nt c�2 _ � Ai�fi�+ Co I� <br />R�,ofrra Co ��r�ucna� I��� �� <br />CONTR.LICENSEN 1- ��� IL) MONI Vl.l _ V, <br />U8E OF BUILDIN(i <br />HEATSOURCE <br />_ Elecidc �Gas __ Other <br />WORK DESCRIPTION <br />R�e-2ooF � �c�uove � ���C� �aoF <br />N0. I TVPE OF Fl%TURE OR ITEM <br />Toilet <br />Bathtub <br />Levatory (wash basin) <br />Shower <br />Kitchen sink 8 disposel <br />Dishwaeher <br />Clolhes washer <br />Water healer <br />Sink (aervicebar/mop/etc.) <br />Backllow preventer <br />Urinal <br />Drinking Fountain <br />Floor drai� <br />Greaselrap <br />Roof drains <br />Olher <br />U <br />0 <br />P RMR <br />r� ����/ <br />c �ev�� b <br />CONTRACT PRICE OF WORK <br />� 6, I 30 �y <br />N0. I TYPE OF fl1(TUlIE OII ITEIM <br />fUC - air handllnp unita <br />Forced eir systems <br />Oas piping <br />Weter heeter <br />Ges lireplace <br />Oasrange <br />Clothes dryer <br />Renpe hood <br />Ezhaust lan <br />Heat pump <br />Unil healn� <br />Boiler <br />Relrige�ation <br />Woodstove <br />Other <br />�'ITY OF EVERETT LOCAL 8ALE8 TAfI CODE 18 J1N3 <br />I heraby ceritily thal I have read and ezamined ihis applicetian and know Ihe seme lo be In•3 and cortect. All provisione of lawa end <br />ordinaces governing this lype ol work will be complied with whether specilied herein or not. The grantinp ol a permit doea nol preaume <br />to give eutho�ily to violate or cancel the pr�vision ol any other slate or local law regulating construclion or lhe peAormence ol <br />construct�en. That I am authorized by the owner ol this praperty Io pertorm the work lor which epptication is made and I comply with Ihe <br />State Contractors Law 18.27 RCW and 298200 WAC. � � <br />