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' P�RMIT APPLICATION <br />� <br />� CITY OF EVEREiT PERMIT SERVICES <br />I 3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8t31,. — F�,X 425•257-8857 — www evereltwa.org <br />I_ APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM <br />�� SITE ADDRE55 . ��win PARCEL iAX I.D. N <br />- �� ��—���-�-�? --�d��131 G <br />IFGAL lOTNO 9LOCK TRAC7 <br />PERMIT N <br />iiE:sc� j3`] rmn.ao ✓�P�►l...rcNE E�T7`i`�S <br />1�-A-�� F�-a-N�i7 �J <br />TENANTNnME <br />� ��" <br />� ����.s u� • �P-�", wa q �2v3 <br />ICONTACT FOR PERMI7 PHONE <br />ICONTRACTOR n AO�RESS CIIY/ZIP PHONE <br />� CONTR. LICENSE f v w " ^ ' "" `� 'TS' �'D W� <br />—USE OF BUILDING ------� HEAT SOURCE CONTRACT PRICE OF WORK <br />I S • F. R� . ✓ Elednc _ Gas _, Other � � �p �'p <br />1 <br />IWORKDESCRIPTION . AA � �,A �.�y� S•F <br />wvY .x� �" 1 CJ <br />�/ < E � 6 a2,ae�-�- . <br />INO. TYPE OF f'IXTURE OR ITEM <br />� Toilet - -- <br />I �Balhtub <br />Lavatory (wash basm) <br />� Shower <br />Kilcl,en s�nk 8 d�sposal <br />i -_ Dishwasher <br />Clothes washer <br />I _ Laundry I�ay <br />I _ Sink (service�badmopietc � <br />_ BackOow preventer <br />Urinal <br />Dnnking Founlain <br />I _ floordrem <br />� __ Grease Irap <br />� Roof drains <br />I - OUter---------- <br />u <br />MtI:HANIGAL <br />NO. I TYPE OF FIIITURE OR ITEM <br />_ NC - au h�ntlling unils <br />FnrceA nir syslems <br />Gas pipiny <br />Waler heater <br />Gas tireplace <br />_ Gas range <br />Clolhes dryer <br />Rangehood <br />,_ Exhausl fan <br />Heatpump <br />Und healer <br />Bodcr <br />fteingeration <br />_ Woodstove <br />Olher Z. ���% <br />CITY OF EVERETT LOCAL SALES TAJ( CUDE IS 7106 <br />I hereby centily Ihat I have read and examined Ihis apphcahon antl know ihe same lo be true and correct All pmvisions of laws and I <br />nrdinaces govemmg Ihis type of work wdl be complieA wiih N'�ether specified herem or not The gran6ng of a permd does not presume � <br />to yrve aulhonty to viotale or cancel Ihe provision ol any olher state or local law regulating conslruction or lhe peAormance of i <br />r.onstruc6on That I arn aulhonzeA by ihe owner ollhis property to peAorm Ihe work lor which application is made and I cornply w�(h Ihe � <br />State Conlraclors Law 18 27 RCW and 296 200 WAC <br />O� <br />