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s,C'�c� � .. <br />�,�����{- F�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />� C" � 3200 CEDAR STREET, EVERETi', WA 98201 <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 <br />333o m�r.� <br />LEGAL LOT N0. <br />DESC. <br />OW ER <br />i�r�-1h�rs fi��v <br />�TENANT NAME <br />��� ��ar�' <br />CONTRACTOR r <br />CONTR. LICENSE # <br />USE OF BUILDING <br />WORK <br />PARCEL TAX I.D. 7f <br />a..e, fi�u., <br />BLOCK TRACT <br />ADDRESS CITY2IP <br />'o� _ 7� �� .�t�rnc�c�. ��n� <br />ICOt�TTA T FOR PERMIT <br />�j- 7>D �1'IC1J�o���l1.�,1 �� . <br />ADDRESS CITY2IP <br />�iX�u'QS <br />HEATSOURCE <br />_ Electrc � Gas _ Other <br />h eok - �`-� PoY-k�z. s��� �-N-� <br />�p�-; �t �; Q�� <br />N0. I 7YPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />�ishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Flaor drain <br />Grease trap <br />Raof drains <br />Other <br />FERMIT # <br />� — <br />PHONE � <br />9�r�.3g .��o <br />PHONE <br />uQr2H-�a�i ��-a <br />PHONE <br />CONTRACT PRICE OF WORK <br />/ o0 <br />)'t' N'/�f " � x � 3�8 `' � <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplacs <br />Gas range <br />Clothes d��er <br />Ranga hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF cVERETT LOCAL SALES TAX CODE IS 3105 <br />I I,ereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of Iaws and <br />ordinaces governing ihis type of work will be complied wilh whether speci(ied herein or not. The �ranting of a pertnit does not presume <br />to give authonry to violate or cancel lhe provision o( any other state or !ocal taw regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to periorm the �ti•ork for which application is made and I comply with the <br />Slate Contractors Law 1p.27 RCW and 296.200 WP.C. <br />