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PLRMIT 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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PARCEL TAX I.D. 0 PERMIT A <br />a-z_ -' <br />rv► csa-I' oc�I <br />LEGA LOT NO. <br />BLOCK TRACT <br />DESC. <br />OWNER <br />_ <br />�' JOO <br />ADDRESS CITYIZIP ONE <br />� / <br />1�Rn)/ U�-�y <br />y/-� // Ll (&"� Ail � f At')��c—(<Z) �Z <br />TENANT NAME <br />I CONTACT FOR PERMIT PHONE <br />CONTRACTOR <br />ADDRESS CITYIZIP PHONE <br />CONTR. LICENSE M <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />S F ' ` <br />Electric )� Gas Other <br />I <br />112 000, <br />I <br />_ <br />00 <br />WORK DESCRIPTION <br />&A' 5 APp(--t.aN r'-z S <br />PLUMBING <br />MECHANICAL <br />OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />A/C — air handling units <br />tNO.TYPETYPE <br />wash basin) <br />Forced air systems <br />Gas piping <br />k 8 disposalGas <br />Water heater <br />lireptace <br />r <br />Gasrango <br />asher <br />Clothes dryer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />_Range <br />hood <br />_ <br />_ <br />Backfiow prevenler <br />Exhaust fan <br />Heat pump <br />Urinal <br />Flooring iFountain <br />Floor drain <br />_ <br />_ <br />_ <br />Unit heater <br />Boiler <br />Refrigeration <br />Grease trap <br />Roof driins <br />Other <br />_ <br />Woodstove <br />Other <br />— <br />— <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceotity, that I have read and examined this application and know the same to be true and correct. All previsions of laws and <br />ordinacos governing [his type of work will be complied <br />with whether specified herein or not. The granting of a permit dons not presume <br />to give authority to violate or cancel the rovislon of any other state or local law regulating construction or the performance of <br />construction. That I am authodze <br />St:te. Ca <br />he' is property to perform the work for which application Is made and I comply with the <br />ctors La 18 7 <br />and 6.200 WA <br />ure o ner/`ontrac /Aut o ze gent Mto v `� <br />