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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 <br />SITE ADDRESS PARCEL TAX I.D. A PERMITIf <br />(_ )' . 3C<`.. c I C'} L. i �l U 1 <br />LEGA LOT NO, BLOC( TRACT OR SUBDIVISION <br />DESC. 0, 1., ; '\ e , -t , ( C 1" (Lo } cc.-' 0 <br />I , <br />TENANT NAME <br />CONTACTFOR <br />1�1.11e'zl C :eieM q UIj L(1S i 17 2-tW <br />LI 2s "1 SL 4 ;7t IQ r ;�AJ6 <br />I tm <br />CONINALHAt I , �, . 1 '..... r)t 1. lr('L'• AOunCOD v <br />IC%IIr 1X45k CcrK..5r .net <br />IktiuO r.,r•vC 1.1�J A-3u�i <br />CONTR. LICENSE `.IA H,�6L-r�. Cl��l.•F) ��dl-c (, n+� CIf11ll <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORX <br />a.Y LL { I CMG/:a IW_.L. <br />Electric ._- Gas Other <br />WORK DESCRIPTION <br />, <br />IIO. I TYPE Of FIXTURE OR ITEM <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C - air handling units <br />Forced air systems <br />Bathtub <br />}_ <br />Lavatory (wash basin) <br />Gas piping <br />1 <br />Shower <br />=Water <br />heater <br />Kitchen sh* 8 disposal <br />Gas fireplace <br />i <br />Dishwfsher <br />Clothes washer <br />= <br />as range <br />Clothes dryer <br />Water heater <br />_ft_L <br />Range hood <br />Sink (service/bar/mop/etc.) <br />r ( <br />Exhaust fan <br />' <br />Backgow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />_ _ <br />Boiler <br />Floor drain <br />Rohigeration <br />-_ <br />Grease trap <br />_ <br />Woodstove <br />_ - <br />Roof drains <br />Other _ <br />Other <br />-.. <br />CRY OF EVERETT LOCAL SALES TAX t.D<lE IS 3105 <br />t hereby ceritily that I hsve read and examined this application and know rtie same to be true and correct. All provisions of laws and <br />crdinares governing Ih:s 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 <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 />Slate Contractors Law 18.27 RCW and 296.200 WAC. <br />ale / <br />