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� <br />PERMIT APPLICATION , % <br />CITY OF EVERETT PERMIT SERVICES ` <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />'s 'i 'S �� M c I, ,,, ...;. oJ� n., r <br />LEGAL LOTNO. BLOCK <br />DESC <br />OWNER <br />��'JS nJhfJ'`' �..LL <br />TENANTNAME <br />Tl.ur�.1 S•��r�-1 <br />PARCEL TAIf I.D. N <br />UO`i �`��='iq�.17�0 <br />TRACT <br />'j1� 5.�:...Aar <br />CONTACTFOR[P�ERMIT <br />_ •� tJ�^Q � / l tt.%� <br />S Q.S ���tJ l„-� c� <br />PERMIT +� <br />PHONE <br />�2j ,���,,.�z2� <br />CONTRACTOR ADDRE55 n CITY/ZIP PHONE <br />f�1i,�'rl.�.-�<�1- 1-�t�-i;�,,.s i101� �t� �f�..� 7t�` !�-Z.'�� �S.:�i7 '-�2) 2.5� C:SI:� <br />CONTR.LICENSEp � <br />�� �� N w�-� � 7 S )� C: 'h n � c, �, <1 � L � G �l <br />USE OF HUILDING ( HEAT SOURCE I CONTRACT PRICE OF WORK <br />WORK �ESCRIPTION <br />� ` � �,�..�.� 1 �1 n c, �1 q <br />��I a.dR.���.,! ,Ur...:,�g <br />_ ElecMc �Gas _ Other I � 7. � �=+� <br />_.� rc �,� r�-'-c_%�^'�� <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toi!et <br />6alhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Cbthes washer <br />Laundry tray <br />Sink (service/bar/mopletc.) <br />DackFlow preventer <br />Urinai <br />OrinV � �g Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air sy:.;�ms <br />Gas piping <br />Water heator <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Rangehood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretion <br />Woadstove <br />Other <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS J105 <br />1 hereby ceritiy that 1 have read and examined lhis application and know the same to be true and correcL All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting ot a pertnit dces not presume <br />to give aulhonty to violate or cancel the provision of any olher state or local law regulating construction or the performance of <br />construction. That I am aulhorized by the o�vner of this property to perfortn the work for which application is made and I comply with the <br />State Contractors law 1827 RCW and 296.200 WAC. , <br />��� <br />