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SITE ADDRESS <br />3 �� <br />LEGAL LOT NO. <br />�E�MiT APPLICATIVN <br />CITY OF EVERETT FERMIT SERVICES <br />3200 CEDAR �TREET, EVERETf, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS AR'E ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL T.4X I.D. # <br />!S�'' �4�c �r� �6 o/o�1i� �0000 <br />TENANT NAME <br />�5'RACTOR ��,� <br />CONTR. LICENSE # �GG <br />USE OF BUILOING <br />WORK DESCRIPTION <br />�nth-qc%!`N <br />TRACT OR SUBOIVISION p <br />HUUKCJ:� <br />/Y>y /'�Lc O ds7s' <br />CONTACT FOR PERMIT <br />O<�J �/�"—� <br />n�oa <br />�09% /ft•'�l <br />� <br />HEAT SOURCE <br />_ Electric �' Gas _ Other <br />��ji � �23 <br />NO. I TYPE OF FIXTURE OR ITEM <br />�Toilel <br />9a�htub <br />�. Lavalory (wash basin) <br />Shower <br />�_ Kitchen sink 8 disposal <br />� Dishwasher <br />/ Clothes washer <br />� Water heater <br />Sink (service/bar/mop/etc.� <br />Backllow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />P�RMII� � <br />C ���D�OD <br />PHONk:�1 f �y� <br />�/f6 � <br />o �� �� <br />PHONE <br />E-MAIL <br />PHOPTE <br />ri� ��a� �� <br />r �Jp � <br />CONTRACT P ICE OF WORf( <br />� /� DoZ� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air hantlling units <br />�_ Forced air systems <br />� Gas piping <br />_� Waterhealer <br />�Gas fireplace <br />Gasrange <br />� Clothes dryer <br />� Range hood <br />� Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Waodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this applicalion and know lhe same to be true and conect. All provisions of laws and <br />ordinaces go��ernin� this type oi work will be complied with whether specified herein or not. Tne granling of a permit does n�t presume <br />to give aulhority 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 o( this property to per(orm the work for which applicalion is made and i comply with the <br />State Cont[actors Law 18.27 RCW and 296.200 WAC. <br />`�3 <br />