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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 PIM <br />SITE ADDRESS PARCEL TAX I.D. N P/ MIT If <br />Ca. <br />y : <br />LE <br />LOT NO. BLOCK TRACT OR SUBDPMON 9 \ <br />DESC. h I:rl ;_c:n�' C a.+cbtr� CcL✓� l clti�/ ) <br />:NANT NAME <br />�- <br />� X t C <br />vd;elf %us, tf15 117 2no <br />i,A[klC�(tilrL I . .U, <br />PNUNE Lt I',-I-,L. �I/j I(' / JCL <br />c UA11 ('... "I.. w. r" iY..n..1 340 'in <br />-CONTRACTOR 1 I f.• I r.... C(i Cr .i f,r.. ...,...,��� __ _. <br />IGIrt IJ, y'.t (,rp�.'1 .CFI <br />k r�or 1J�J A •-xY.- i <br />CONTR. LICENSE I <br />USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br />#•v�( (' m,l� tlrt,alV(I ((Krc <br />1 Electric, Gas .Other <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ Toilet <br />Bathtub <br />Lavatory (wash basil,) <br />t Shower <br />Kitchen sink & disposal <br />_ Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.( <br />Backflow preventer <br />Urinal <br />_ Drinking Fountain <br />Floor drain <br />Grease trap <br />Root drains <br />Other <br />NO. I TYPE. OF FIXTURE OR ITEM <br />_ A/C - air handling units <br />I Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />i Clothes dryer <br />_ Range hood <br />Exhaust fan <br />_ Heat pump <br />_ Unit heater <br />Boiler <br />Refngeratien <br />Woodslove <br />CRY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritily that I have read and examined this application and know (he same to be true and correct. All provisions of laws 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 provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296,200 WAC. <br />