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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 I , - W L — <br />SITE ADDRESS y1 <br />LEGA. LOT NO. BLOCK <br />DE <br />i <br />UVVnr.n <br />G'� err✓F./1'1�� /i/�/cyF:sf LLG <br />TENANT NAME I CONTACT FOR PERMIT <br />CONTRA ADDRESS U I R/GIr rnv <br />tES�c <br />L� Ile, yl�tfy.���///��Pz�l� zcz�5�its i <br />CONTR.LICENSE# j )O�;� r <br />USE OF BUILDINGV�k <br />I � HEAT SOURCE CONTRACT PRICE OF WORK <br />�j /�� DES/ d<j _Electric Gas_ Other <br />Al/'`q 000 <br />WORK DESCRIPTION <br />A <br />PARCEL TAX I.D. # RMIT # <br />36_Z g d y363P�Q/� 36L i4 `�' � o�Gt�(J <br />tACT OR SUBDIVISION #35 <br />' <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet /// <br />Bathtub / / <br />Lavatory (wash basin) <br />Shower / 1 <br />/ <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />PHONE W;- ' 4h �j <br />E-MAIL <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />_ <br />1_ <br />Forced air systems <br />J- <br />Gas piping <br />Water heater <br />Y <br />Gas fireplace <br />Z <br />Gas range <br />Clothes dryer <br />�L <br />Range hood <br />I' <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />_ <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify 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 be complied with whether specified herein or not. The granting of a permit does not presume <br />to give onty to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />Cons ct' n. That I am at fioyj -eyt by the owner.-df ti property to perform the work for which application is made and I comply with the <br />c,�r n rractnrc I aw #� 2 and 296.200 C. <br />re <br />1(6 <br />