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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 - www,everettwa.org �. /, � S �' �•� <br />C <br />r ��? � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DE817 3 CREDIT CARDS ARE NOT ACCEP7ED <br />�tcaL L07N0.� BLOCK <br />DESC. <br />owN R � <br />A���tn `��OMEs �� IDI� <br />TENANT NAME <br />Y\� I WS <br />CO TR CTOq <br />�r� sc�n �VoMe�.Jn�. <br />CONiR, LICENSE 1 I� �•�� S� Y aby � <br />USE OF BU!LDING <br />�� <br />WORH DESCRIPTION <br />ND• I TYPE OF FIXTURE OR ITEM <br />Todet <br />8athtub <br />Lavatory (waeh basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Launtlry tray <br />Smk (servicelbar/mop/etc ) <br />Backflow preventer <br />Unnal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Othei <br />PARCEL TAX I.D. N <br />[814� <br />TRAC7 � <br />.�t� ( �r'-. a � �1 �c� ✓ -� <br />AODRESS CITY2IP <br />�9�'een�,Jv �Is-y`I..3 c�ue�cN�g�D <br />.0 TAC7FOqpERM1T <br />nooAess �— <br />�arne GS owne( <br />HEATSOURCE <br />_ Electric ,yLGas _ Other <br />N0. <br />PERMIT k <br />� <br />� ��� � <br />PHONE <br />CITYILP PHONE <br />�( Z.ti •�(3� �(�3fiQ <br />CONTRACT PRICE OF WORK <br />''�S1(�� � R (� <br />� <br />TYPE OF FIXTURE OR ITEM <br />A/C — av Aandling urots <br />Forced eir aystema <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasranga <br />Clolhes dryer <br />Range hood <br />Exhaustlan <br />Heatpump <br />Unil heater <br />Boiler <br />Refrigeration <br />1Noodstove <br />Olher_�_ <br />CITY OF EVERETT LOCAI SALES TAX CODE IS J105 <br />I he�eby cerihfy thal I have read end examined th�s applicalion and know the same to be true and coirect All provisione of lawe and <br />ordinaces goveming lh�s (ype of work will be complied with whether spenfed herein or not. The granting af a permit doee not presume <br />to give authoriry to violate or cancal lhe provision of any other state or local law regulating construcUon or Ihe performance of <br />wnstruction. That I am authorized by the owner of Ih�o proper,y lu pertorm the work for whid, appGcation ts made and I comply with Ihe <br />State Contractoro Law iB 2hRCW and 296 200 WAC <br />�� � x l �,�� :LJ � u� �-��.�%;G <br />