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SITE ADDRESS <br />LEGA LOT NO. <br />DESC. (���� <br />TENANTNAME <br />PERMIi 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. M <br />j��T �i- 4 0 15 <br />BLOCK TRACT OR SUBDIVISION • <br />4 "1 <br />ADCRESS <br />(i�2o Ird�t �.tT WAY K 2"so <br />I CONTACT FOR PERMIT <br />PERMIT M <br />Lo� -Z4�•� <br />PHone � • sTs •�� e <br />J�pr� a M►wvu�sll�•T•c.oM <br />lr VI� 1 R/LL� 1 Vn v� �� ru• <br />E�w� �►+�+c.t� n. z?q �p�wr,ua 31oeK�r�E wA 99zez <br />CONTR. LICENSE / 1i i ., <br />�L� _.__ _ . __ �!/�fsl� /...w..��n .. ..�r n�+T�rW�1+Yl� ! <br />USE OF BUILDING <br />HEATSOURCE <br />_ EleIXric ✓Gas _ Other <br />Se� •SSS .��.l. ! <br />C� V �/i1� <br />CONTRACT PRICE OF WORK <br />2 S.00I� � <br />WORK DESCRIPTION <br />Wz�.U,. (z) ►�wz.'cu�cw.�S'"' �eY.'fse�ww �p+a�o�soK.s n�an R„U.. t�uwT v.a�.1� <br />NO. � T'PE OF FlXNRE 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 />Slnk (service/bar/mopletc.) <br />Backflow preventer <br />Unnal <br />Dnnking Founlain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Other ___ <br />TYPE OP flXTURE OR ITEM <br />AIC - air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Retrigeration <br />Woadstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby celify •;hat I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances go�eming lhis iype of work will be compiied with whether specified herein or nol The gran6na o( a permit dces not presume <br />to give aulhonF� to violate or cancel the provision of any other stale or lopl law regulating consWdion or the perfortnance oi <br />construction. iliat I am authorized by the owner of this property to perform the vrork for which applicatlon is made and I comply with the <br />Stale.Contradurs Lav/ 1827 RCW and 296.200 WAC. <br />