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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDA R <br />R ST EET, EVEREI T, WA g8201 <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 PARCEL TAX I.D. # ERMIT # <br />c l ' SIND RD. # 40-3 <br />LEGAL LOT NO. BLOCK TRACT _ <br />DESC. <br />TENANT NAME CONTACT FOR PERMR PHONE <br />.R(i It.1('� BUILDIUG 40-31 I (CAUL_ ORPERm 253-633-1248 <br />CONTRACTOR F I RE S i .S TEM i WEST ADDRESS CITYMP PHONE <br />215 FRDNTAGC P-D^D N. PACIFIC J-53P3 -3 -1246 <br />CONTR. LICENSE N I r RE 5W L 14 0 I SL-1 I TC 3 LuA 93 04r7 <br />USE OF BUILDING <br />HEATSOURCE <br />CONTRACT PRICE OF WORK <br />" � C.CL - <br />+ � r. r.� +i LN we S�-IOP EledNc Gas - Other I � , - <br />WORKDESCRIPTION -�QOVIOE (b) SPP.Ir KLFCS F'01L RELOCATED CMM Rr)OM <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 (sorvice/badmop/etc.) <br />_ BacMbw 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 />AIC - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireolace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br />I hereby certify 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 heroin or rat. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local low regulating construction or the performance of <br />construction. That 1 am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate Co9tracto7 Low 18.27 RCW and 296.200 WAC. <br />