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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-E810 - FAX 425 257 8857 <br />- - -www.everettwa.org I� � C,� �, ;� _ �� i /_ <br />09 F <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED I <br />DESC <br />1r�,�n <br />TENANTNAME <br />1 \ PARCE�T� X I� <br />� w y <br />BLOCK TRACT/- <br />ADDREL <br />�-Y�G ��121 �P,fqfee111,�v ��5-Y <br />CO TR CTOR <br />r san �VoM�,.�nc. <br />CONTR.UCENSEN y��YsyNYaa5L3 <br />USE OF BUILDING <br />WORK DESCRIPTION <br />N'�", PLUMBING <br />NO. I 7YPE OF FIX7URE OR IiEM <br />—L_ <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kdchen sink 8 disposal <br />Dishwasher <br />Clotiies washer <br />Laundry Iray <br />Smk (service/bar/mop/etc � <br />BacMBow preventer <br />Urmal <br />Dnnking Founlam <br />Floor drein <br />Grease trap <br />Rool drams <br />Olher <br />I LONTACT FOR PERMIT /� <br />. ( Y l. � �' `` <br />ADDRESS <br />�arne �i, uwne� <br />HEATSOURCE <br />_ Eleclnc � Gas _ O�her <br />NO. <br />PERMIT k <br />�-lD� ('c �- c � , �,�� � <br />!�� V� <br />CITYIZIP PMONE <br />�udl ��2lxl �{Z5-ti3��a�q <br />PHONE <br />�ITY IP �p�� <br />�-I Zb"-N 3�i �(�2,LQ <br />I CONTRACT PRICE OF WORK <br />��1 �'Fi' <br />�- 13� <br />TYPE OF FIXTURE OR ITEM <br />I �vc — air nandhng units <br />Forced air systems <br />Gas pipmg <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />E■haust fan <br />Heat pump <br />Und heater <br />Boder <br />Refngeratwn <br />Woodstove <br />CITY OF EVERETf LOCAL SALES TAI( CODE IS ]fOS <br />I hereby cenldy thal I ha��e read and exammed this apphcalion and know the same to 6e true and conecl All provisions of laws end <br />ordinaces govem�ng this lype of work will be comphed with whether specdied herein or nut The granting of a permit does no� oresume <br />to grve authonty lo vwlate or cancel ihe prowsion of any other state or local law regulating construcUon or Ihe pertormanca or <br />construct�on Thal I am auttionzed by Ihe owner of this property ;o paAorm the work for wh�ch applicat�on is made and I comply w�th Ihe <br />State Conlractors Law 18 27 RCW and 296 200 WAC <br />/% ' . _1.0 / //�. ' LZ� <br />