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PE,IMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everpttwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />J` oZ y 77 2 rJ <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGA LOT N0. BLOCK <br />TRACT <br />DESC. <br />OryW/NLRR <br />ni2/'cli <br />ADDRESS <br />Y� <br />Shy rjj 3�-w <br />CITY/ZIP PHONE <br />TENANT NAME <br />.ky8-20ri y2Siy86 <br />I CONTACT FOR PERMIT <br />PHONE <br />CONTRACTOR <br />ADDRESS <br />CITY2IP PHONE <br />CONTR. LICENSE 0 <br />USEI'OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />4 o vti <br />II Electric Gas Other <br />�Sov ad <br />WORK DESCRIPTION <br />�vt5%yl�9�rar� a� <br />woo C-f 5-ILov� <br />PLUMBING <br />MECHANICAL <br />N0. I TYPE OF FIXTURE OR ITEM <br />NO <br />TYPE OF FIXTURE OR ITEM <br />_ iaaet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflaw preventer <br />_ Urinal <br />_ Drinking Fountain <br />Floor drain <br />Grease trap <br />_ Roof drains <br />—i Other _ <br />_ .v - air nananng units <br />Force •irsystems <br />Gas piping <br />Water heater <br />_ Gas firep'ace <br />_Gas Tango <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />_ Heat pump <br />_ Unit heater <br />_ Boller <br />Refrigeration <br />�1 Woodstove <br />_ Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this 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 />State Contractors Law 18.27 R}CW and 296.200 N/AC. <br />