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SITE ADDRESS <br />� ��If <br />LEGAI LOTNO. <br />DESC. <br />PERMIT APPLICATION <br />CITY O� rVERET'f PERMIT SERVI�ES <br />320� CEDAR STFEET, EVERETT. WA 98201 <br />425•257-8810 — Fl,X 425•257•8857 — www.everettwa.org <br />APPLICA � IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. M <br />r <br />BLOCK I TRACT OR 9UBDIVISION I <br />N <br />_v <br />TE�ANT NAME I CONh1CT FOR PERMIT PHON�it-yj) �7yz _]� ��t� <br />. r i� <br />CONTR. LICENSE 0 � <br />LvF.� �`-� rZ �u i <br />U.SE OF BUILDINO <br />( � �- �IC L- � l.t�l2l�h1�1/�.,C. <br />�r2��,z-:i�fy <br />HEAT SOURCE I CONTHACT PRiCE OF WORN <br />k�L!�anc __ Gas -_ . Othor � O � C�� .`�� <br />WORK DESCRIPTION — {. y,{� �� ;iy < <� y (rtu li I �'�Sy.'jj'�ti � r -(�{� <br />('U�^.l:�Sll 'z- �.{-:•;;vil.i �u� � y LL.• tCw.4- <br />��� i�ySfZ-Nn� l2e;r-f�r:_Urt+�-i t�����n�r� � �IZfI�� <br />N0. I TYPE OF FI%TURE OH ITEM <br />ToiL:i <br />Dathtub <br />Lnvatory I�vash basin) <br />Shawe� <br />KAchen smk 8 disposal <br />D�shwashcr <br />Clothes washer <br />Wlte� hoator <br />S�nk �serviec�bamnop�cic 1 <br />Oackllow p�ovcntcr <br />Urinal <br />Drinking founlain <br />Floor dra�n <br />Grcasclrnp <br />Roof drains <br />Olher <br />N0. � TVPE OF FI%TURE OR ITEM <br />NG — air handlinc� un�ts <br />Forced air systems <br />Gas piping <br />�Vatar heatOr <br />Gas 6replace <br />Gas ianga <br />Clothes dryer <br />F�angc hood <br />[KhauSl lan <br />Heat pump <br />Unit heater <br />Ooilor <br />Rofrigoration <br />1Yoodstov <br />otnor c:��, �L1u�1 _ <br />CITY OF EVERETT LOCAL SAIES TA% COOE IS �105 <br />I hereby centdy that I have read and exammod Ihis application and know Ihe samo to bo Irue and correcl. All provisions ol laws and <br />o�dinaces goveminp Ihls typa ol work will bo complied with whether specilied herein or no�. Tho granting of a pormll doos not piosumo <br />to g�ve authm�ly to violale oi cancel Oio provision of nny other state or local law regulating constmction or Iho portormance of <br />construcuon. That I am aulhorized by Iho ownar ot Ihis propeny Io perlorm Ihe work lor which applitation is madC and I comply wilh lho <br />Stato Contractors Lnw IB.27 RCW and 2�J6.200 WAC. <br />