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SITE ADDRESS <br />LOT NO. <br />TENANTNAME <br />Gc Tt.N <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 />w I ie-"tv I GCS-.--�, ( 1j_7L( <br />BLOCK TRACT OR SUBDIVISION # <br />CONTACT FOR PERMIT <br />C=STF(C-K <br />PHONE <br />PERMI # <br />f7) S;ru -2_S <br />>SSo_73sv <br />reecon 51 , ca4 <br />C N-TRACTOR ADUKt35 II — <br />11)AN-2c--� Cr�1���ucTtoly, INC, (4(o5 R+" PL. s)_0:c-lu&Jc-,c4.;4 lF 'g <br />CONTR. LICENSE # n ANREG <br />USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br />AFL. j� ec U ti <br />WORK DESCRIPTION <br />i /J 57_k(-L-�91_Ft D/S uF <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backfiow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />_ Electric -X Gas _ Other <br />I&] <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 />Rangehood /� p2 i <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 3105 <br />hereby cerilify that I Have read and examined this applicatior 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 'her specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any oth ., ate or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this pro. rly 1 perform the work for which application is made and I comply with the <br />M <br />