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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I )L — I —l o <br />SITE <br />M <br />PARCEL TAX <br />�ADDRESS <br />, <br />�PrnERMIT <br />/I�.D.�III <br />l 'r. JIJ C) /rl ���—Z <br />LEGAL LOT 110. BLOCK <br />TRACT OR SUBDIVISION 0 <br />DESC. <br />-ADDRESS <br />PH N <br />11�LS • 343' <br />\I \(� C'`>�r0� 1 I I (>� <br />c��l �t .�U(�{' <br />1P"' <br />TENANT NAME I <br />CONTACT FOR PERMIT PHONE <br />EIrINL <br />�oNrn.�lc^BE�i k U(k <br />yil r� �t� t� tiCht �t CC � <br />USE OF BUILDING <br />HEATSOURCE CONTRACT PRICE OF WORK <br />Ele,:Idc Gas _Other Q� <br />WORK DESCRIPTION <br />AL <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application anti know the same to be true and correct. All provisions of laws and <br />be with whether specified herein or no:. The granting of a permit noes not presume <br />ordinances governing this type of work will complied <br />or cancel the provision of any other state or local law regulating constructhn or the performance of <br />to give authority to violate <br />That I am authorized by the owner of this property to perform the work for which applicatioi is made and I comply with the <br />construction. <br />8.2RCW and 296.200 WAC. <br />Cona.r'w�itr.c'lor <br />1 Y � <br />/ <br />-$�n a Aul odzed Agent <br />ate <br />PLUMBING <br />MECHANIC <br />NO. TYPE OF FIXTURE OR REM <br />NO. TYPE OF FIXTURE OR ITEM <br />A/C -air handling units <br />_ <br />Toilet <br />Forced air systems <br />Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />Water healer <br />_ <br />_ <br />_ <br />Shower <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />_ <br />Dishwasher <br />_Gas <br />renae <br />Clothes dryer <br />Clothes washer <br />Water heater <br />Sink (aervlcelber/moplelc.) <br />Backflow prevenler <br />Urinal <br />_Range <br />_Heal <br />_Unit <br />hood <br />Exhaust an <br />pump <br />heater <br />_ <br />_ <br />_ <br />_ <br />Drinking Fountain <br />Floor drain <br />_Boiler <br />Refrlguralici <br />Woodstove <br />_ <br />_ <br />Grease trap <br />Roof drains <br />Other <br />—_ <br />Other <br />- <br />_ <br />_ <br />i <br />