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PERMIT <br />APPLICATION <br />CITY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX <br />425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />—�-7 <br />SITE ADDRESS -1 r <br />PARCEL TAX I.D. # <br />PERMIT # <br />`7no3 w r cf of,40A-V <br />f�( lU- om <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. <br />OWNER ADDRESS CITY0P PHONE <br />n <br />I o 6 <br />TENANT NAME <br />i3 bE I ri <br />CONTACT FOR PERMIT zPH E <br />✓76-ZryyS <br />E-MAIL <br />CONTRACTOR <br />4-l7J tJ G6D rCC# <br />so CITY/ZIP PHONE <br />P&YMAO <br />CONTR. LICENSE # <br />�0 (�� <br />CO, 7 <br />f���L'�17Ur1 /0 <br />USE OF BUILDING �D/��,1aCJ <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric _ Gas _ Other <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR rrEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />A/C - air handling unity <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />_ <br />_ <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />_ <br />_ <br />_ <br />Drinking Fountain <br />drain <br />Grease trap <br />Boiler <br />Refrigeration <br />Woodslove <br />_ <br />_Floor <br />_ <br />_ <br />Roof drains <br />Other_ <br />Other <br />CITY OF EVERETT LOCAL SAL2S TAX CODE IS 0105 <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 />ordinates 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 stale or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this propepy to perform the work for which application is made and I comply with the <br />Slala Contractors Law 1,8.27,RCW and 296.200 WAC., <br />