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- �>i-o <br />PtftOVIIT APPLICATIGN � <br />ClTY OF EVERETT PERMIT SERVICES � <br />3200 CEDAR STP.EET, EVERETT, WA 98201 � <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org j <br />I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # PERMITl7�7 � <br />�L��� I�� '�i `�� OU3����ODZ�LJOL_ �' �C.s-�� I <br />LEGAL LOTNO. I BLOCK TRACT ; <br />� DESC. <br />; � �,y� �- <br />iTENANTNAME <br />i <br />CONTRACTOR <br />CONTR. LICENSE 71 <br />PHONE <br />NHs��_r-, �/u:�/!r 3�=�� ��r„ ��� _._-��_� r,.-c���[�h.�, �����-�,r��9�,�,� <br />CONTACT FOR PERMIT PFiONE I <br />� .� b l � i [� N':i � �ti ���(/�'�i�'- ��_9 1�� ,.' L�- y,, `% 7 ! <br />� I <br />rl �, � '4l � v <br />USE OF Bl11LDING <br />� <br />�. r'� �. .-� C i � ( n_�; <br />' WORK DESCRIPTION <br />�„��� �I)C�ri��n; <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry lray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountam <br />Floor drain <br />Grease trap <br />� Roof dralns <br />-_I Cther <br />ADDRESS ` <br />I �q/J/�,� <br />( �C'Yl ` :� � �;�, Z , <br />HFATSOURCE <br />�[ Elec'ric _ Gas _ Olher <br />N0. <br />Cj�IP/�1 JPC�NE� V � / �ZC/(J <br />� <br />/, �7/US <br />CONTRACT PRICE OF WORK j <br />��lJ 1��:�(� � 7l—. ��l <br />II <br />/�� I <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM � <br />,WC - air handling units <br />Forced air systems <br />f,as piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Ctothea dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit neater <br />Boiler <br />ReMgeretion <br />Woodslove <br />Olher <br />CITY OF EVERETT LQCAI SALES TAX CODE IS 7105 <br />'� hereby r,entity that I have read antl ezam:nea this applic�tion and know the same to be true and ocrrect. All prowsions of laws and �, <br />�rnmaces governing this type of work wdl ba camplietl wdh whether specdied herein or not. The granting of a permit does not presume <br />!o give auihonry to vlolate or cancel the provision of any olher state or local law regulating construction or the performance of , <br />:anstruction. That I am authonzetl by the owner of this property to perform the work `or which application is matle and I comply with the � <br />.tare Conlracrors Law 18.27 RC'N antl 296.200 WAC. , <br />