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FEflMR APPLICATION <br />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 <br />rr+PLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />PARCEL TAX I.D. p PERMIT p <br />SITE ADDRESS '7 <br />�/ <br />,,,.4 rr F , r: �, _. <br />LEGA LOT NO. BLOCK TRACTOR SUBDIVISION p <br />DESC. �- <br />OWNEfl ADDRESS CITYIZIP HONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />\E-MAIL <br />ICONTRACnW— <br />CONTR. LICENSE p <br />r/ <br />USE OF BUILDING <br />HEAT SOURCED' <br />CONTRACT PRIC'c OF WORK <br />Electric Gas _ Other <br />L� <br />I <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />N0. TYPE OF FIXTURE OR ITEM <br />Toilet <br />NC —air handling units <br />_ <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Water heater <br />_ <br />Shower <br />Kitchen sink 8 disposal <br />_ <br />Gas Ihaplace <br />_ <br />Dishwasher <br />Gas range <br />Clothes dryer <br />_ <br />Clothes washer <br />hood <br />_ <br />Water heater <br />Slnk(sarvlcePoaUmop/otc.) <br />_Range <br />---- <br />Exhaustion <br />Backllew prevonlor <br />_ <br />Heat pump <br />Unit haelar <br />_ <br />Urinal <br />Drinking Fountain <br />_ <br />_ <br />Builer <br />Refrigeration <br />—_ <br />Floor drain <br />Woodstove <br />Grease hap <br />Other <br />Root drelnB <br />_ <br />Other_ <br />CIT Y OF EVERETT LOCAL SALES TAX CODE IS LIDS <br />I hereby cerilily that I have road and examined This application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this typo of wo1e will be complied with whether specified heroin or not. The granting of a permit does not presume <br />local law regulating construction or the performance of <br />to give authority to violate or cancel the provision of any other ststo or <br />corlstruclionJhat I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Lew t8.2 RCW and 296.200 WAC. — <br />9gnatum of Owngr�Conlracto/ ulhonz goof Ie <br />F <br />