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PERMIT APPLICATION <br />l CITY OF EVERETT PERMIT SER=ES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810--FFAt'X 425-25F-88517 - www.elverettwai.org lr/ <br />APPLICATIONS ARE ACCENTED FROM 8 AM Try /PM "" EC 8 CR�CDIT CARDS ARE NOT ACCEPTED <br />LEGAL LOT NO. <br />BLOCK <br />DESC. <br />TRACT <br />Souvtil Transit- `ibl S.7ack�,onS1 <br />TENANT NAME <br />N/k <br />CONTRACTOR P <br />CONTR. LICENSE # <br />USE OF BUILDING <br />— <br />=vtvfc. ParkiN9• <br />TAX I.D. # <br />e a vscl led <br />CONTACT FOR PERMIT <br />Val baff_�l <br />ADDRESS <br />PERMIT # <br />xafH,* IVID�i I <br />HEATSOURCE <br />I� <br />PHONE <br />•M,qr. C2��3g8-�ll� <br />CITYIZIP PHONE <br />CONTRACT PRICE OF W ARK <br />Electric —Gas —Other I f I. 5w" • <br />WORK DESCRIPTION 'Q?vvxo tie bU1 togs,co abwe9r615 Car-;e.ta *6 astA <br />i wiuu otround sta (.Age ta'K' -• biy;'ibl _ aadi tl axat dt_nOUAtion C6 of ilWat4r <br />gcpareior swAp, Vrdex (Ound trvcft- 5ca1•es, railroad trocLs uli?GVe-geu#- <br />cxcavete avid 9ca AL _, , o�Nstt and establMJmmpo� far gelw1a11a{}mea-4- <br />NO. <br />YPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />BackBow 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 />_ A/C - air handling units <br />_ Forced air systems <br />_ Gas piping <br />_ Water heater <br />_ Gas fireplace <br />_ Gas range <br />_ Clothes dryer <br />_ Range hood <br />_ Exhaust fan <br />_ Heat pump <br />_ Unit heater <br />_ Boiler <br />_ Refrigeration <br />_ Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />I hereby cerilify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will he complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />Signature of Owner/Contractor/Authorized Agent Date 44/ <br />