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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8851 - www.evereliwa org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />SITE ADDRESS PARCEL TAX I.D. N /P�R as <br />LLGA � LOT NO. BLOCK TRACT OR SUBDIVISION! <br />DESC. <br />21P PHONE <br />NE "'1W REllldN e c� 223-23uu <br />TENANT NAME I FQ�I PENif PHONE ry}7�S+4Ft / <br />10, 1 rrul ��5 754 3�1 e-NAIL <br />_ turn <br />AWN <br />lar� Syo fiw,s 1»]S 15 .�. /}'�N�- Sr,wch,.c 5N,55 �i�'1L i•OI/4 <br />CONM LICENSE 0 �n <br />1 F 1 • "? `F na''�r — I CONTRACT PRICE OF WORK <br />USE OF BUILDING MEAT SOURCE <br />Electric Gas Other <br />WORK DESCRIPTION roe 'r ^ '� .• �,�� 1� �^' <br />PLILIWI MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR RFM <br />_ Toilet __ NC- air handlmgunits <br />_ Bathtub _ __ rorced air systems <br />_ LF,vatory (wash basin) ___ Gas piping <br />_ Shower Water heater <br />_ Kitchen sink 8 disposal - Gas range (' <br />_ Dishwasher _ Gas range <br />_ Clothes washer Clothes dryer <br />_ Water heater Range hood <br />_ Sink (servicelbao.rnpretc.) Exhaust Ian <br />_ Backllow preventer •_ Heat pump <br />_ Urinal Unit heater <br />_ Drinking Fountain Boiler <br />_ Floor drain _ Refrigeration <br />_ Grease trap __ Woodstove <br />_ Roo[drains Other—,------- <br />Other— <br />CRY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerikfy that I have read and examined this application and lu ow the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate Or cancel the provision of any other state or local law regulating construction or the performance of I <br />construction. That I am authorized by the owner of this property to perform Ore work lot which application is made and I comply with the <br />State 'GO 9tjaglors Law�Tw�l and 290.200 WAC. <br />hve recta ul ari: pent ete ' <br />