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L <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-297-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADnFIESS PARCEL TAX I.D. R PERMIT R <br />�&It 5� <br />I FOAL LOT NO. BLOCK TRACT OR SUBDIVISION t • 1 <br />moo.. n .rJ In --1'cz 1 H- 0 01- f/, + Gmz S'v� <br />w\�`�Qw\kt'JU�- 1 <br />TENANTA E C ACT R PETITPNONE J t 11 <br />r ll� � C VJ E-MAII�•1\\. k CNL,'lr <br />CONTR. LICENSE acCa K: ,t((lq ► I (5 <br />USE OF BUILDING <br />WORK DESCRIPTION <br />( \N, it <br />01E <br />. UA 0cf) <br />HEAT SOUi <br />__ Electric _ des _-Other <br />e'iy\ I lP• u 9/ ` <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink R disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servlcelbarlmop'etc.) <br />Backflnw preventer <br />Wrist <br />Drinking Fountaln <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ <br />jrTRACT PRICE OF WORK <br />.1111 -IC1C , )L <br />No. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />_ Forced air systems <br />Gas plping <br />Writer heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />_ Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boller <br />_ Refrigeration <br />Woodstove <br />Other-..___- <br />CITY OF EVERETT LOCAL SALES TAX CODE 19 3105 <br />I hereby cerhify that I have reed and examined this application and know the same to be true and correct. All provisions of taws and <br />ordinates governing this type of work will be compiled with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the rwovislou of any other slate or local law regulating construction or the performance of <br />cons)(uation. That I am authorized by the owner of this properly to perform t work for which application Is made and I comply with the <br />Ste* Contract r(; Lew 15.27 R��W and 296.200 WAG <br />. %fin \ . , � i t v�.-1 <br />I�r�l <br />