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SITE ADDRESS <br />. � i _� f � . <br />LEGA LOTNO. <br />DESC. S �(-� <br />+�, <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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. / <br />"� 7 � C'�'�- I (, r-C�C� :>C� <br />� BLOCK � TRACT <br />S , �-c � � ' i��lc �: '.-�C �! f�'L <br />LV f�l ` � fr�� %' � � l ( C� ,�� L{-� �i 1�' %•� - � (°' � <br />TENANTNAME � � CONTACTFORPE <br />�`-C � Iry�,_�( lC C V,� � h� SY ,R���� �— <br />CONTRACTOR L �—T ADDRESS <br />�71 �`�� �'1�1 �� '�?�.•'�.. �.�C'- 17`e�*�' <br />CONTR. LICF�ISE f <br />i' � � c-..c• � v-. /,�=ct'--7? �' <br />�C <br />� CITY/LP <br />� � 1 � �� h! ( � �.�/ <br />USE OF 9UILDING� HEAT SOURCE <br />C , -� � � l' ��� � L-'Electric ✓as_Other <br />WORK DESCRIPTIO ` - 1 <br />/i�'.;��} (1 �) �?—,�1-_–� �� ` 1 (2�c _ t�.h-1'Cc�c�I .'; C' <br />� � ~(c-. 1� � 't 'r_ �tI`Z.• � •r fif�7�` �' ��"L� �-.� f-,• =� �:' � <br />^� v: . �'-� ` r�•.� � '� f 2--`I� �.•�.-, .._ � � i�� ��� � � < �C`l�:�- �Z- < <br />NO, I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shnwer <br />Kitci�en sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinai <br />Dnnking Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher - <br />� , <br />P�RMIT x � <br />(YI iG v - J C� <br />21 L -' S .'��,��L, I <br />PHONE ���5' �J <br />����,�., -� ) I <br />PHONE <br />7r� L��� "(fG <br />PHONE <br />i.`i y- �' c �.- c� - <br />• G C' � � <br />_� ' I�r� <br />CONTRACT PRICE OF WORK <br />( �,� �� <br />��(.7/ � C�f� �%L, <br />� � � � <br />`'\' i=- '�{ � `� r'N( �7��'� � <br />�)�, .v • 1 t'� C.'� t���� <br />N0. I TYPE OF FIXTURE OR ITEM <br />� AtC - air handling units <br />Forced air systems <br />_J_ Gas piping �-i r. n�{ L�� �� <br />Water heater <br />Gas fireolace <br />Gas range <br />Clothes dryer <br />Range hooc� <br />Exhaustfan <br />Heat pump I � <br />� Unit heater (A�� r i� . C r�•; �� � r+ ; �� �- f �/ ( T <br />Bciler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby centify that I have read and exarrined this application and know the same to be lrue and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or �ot. The granting o( a pertnit dces nol presume <br />to give authority to violate or cancel the provision of any other state or local law reguiating construction or the perfortnance of <br />conshuction�That I am authonzed by lhe owner of this property to perform the work for which applicalion is made and I comply wilh the <br />State Contractors Law 1827� RCW and 296200 WAC. <br />