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RMfT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA �9201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. N PERMIT A <br />3 33n �- �����,� � _ �,� ��,a _ o; 2 <br />LOT NO. I BLOCK � TRACT <br />�.�� s��nn�s- ii,v� <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />�l�Zh+?Z SGr%�/��:- <br />CONTRACTOR ADDRESS CITY2IP PHONE <br />s�2�acrw �. y�,� •�s/c z/ao p,eciF��.q� €Uf��� 2s2-�/rY <br />CONTR. LICENSE 6' E�G� <br />USE OF BUILDING <br />GO/T,c �t�r . <br />WORK DESCRIPTION <br />���-G <br />HEATSOURCE <br />Electric � Olher <br />� �A s �r��ivG <br />NO. I TYPE OF FIXTURE QR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink R disposal <br />Dishwasher <br />Clothes washer <br />Laundry hay <br />Sink (serairr/badmoplotc.) <br />Backflow preventer <br />Urinai <br />Drinking Fountain <br />Floor drain <br />Groasc trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />7,DOo= <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — eir handling units <br />Forced air systems <br />Gas piping <br />Watur heater <br />Gas fireplace <br />Gasrango <br />Clothes dryer <br />Range hood <br />Ezhaustfan <br />fieat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CIN OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby centify Ihat I heve read ond examinod lhis application and know the same to be true and correct. All provisions of laws and <br />ordinaces �c�.�ming this type of work will be complied wAh whether specified herein or not. The granting of a permit dues not presume <br />lo give authority to violale or cancel the provision o1 any other state or locat tew regulaling construclion or Ihe peAormance of <br />construdjon'That�l am aulhorized by lhe ownor ot Ihis property to pertorm the work for which application is mado and I comply wilh the <br />S�ate�ntractors-{.aw 10.27 RGW and 29fi200 WAC. <br />