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PUMIT 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 />Y10- <br />LOT NO. <br />TRACT <br />PARCEL TAX I.D. # <br />CITY/ZIP PHONE <br />TENANT NAM9 <br />,` CONTACT FOR PER <br />I <br />`I� \ <br />PHONE <br />t�l�L/r/•- � art., n <br />�y�J 1 3�/�..(-3'i� <br />CO_ NTRACTOR <br />Mujr2ccc <br />—� //'' <br />ADDRESS <br />CITY/ZIP HONE <br />'� <br />CONTR. LIC E # <br />AA O CC --T <br />/ 4 g7� <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />40(k',r-N <br />- <br />7,:— <br />// <br />Ue, <br />_ Electric _ Gas _ Other <br />I —416490 000 <br />WORK DESCRIPTION <br />(i-)/r/lS -r 3 <br />NO. I 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 />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backgow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />I hereby contify 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 permli does not presume <br />to give au rity to wo a or can the provision of any other state or local law regulating construction or the performance of <br />constru on. That I authorized the owner of this property to perform the work for which application is made and I comply with the <br />State ontraGtor w 8.27 RCW nd 296.200 WAC. <br />/i= / ' � <br />