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F�RMIT APPLIC/�TIC � J <br />CITY OF EVERETT PERI�,�IIT SERVICES <br />3200 CEDAR STREET, EVEF cTT, WA 98201 <br />425-257-BB10 — FAX 425-257-8BE! —www.everettwa.org <br />APPLICATIONS ARE ACCEPTE'.) FROM 8 AM'f0 4 PM <br />SITE ADDRE55 ^� I� Qp � yy�,�/� �Q 1� <br />L I�-11 I lul �� 1� <br />LEG LOTNO. � I� BLOCK — <br />DESC. �'�T <br />OWNER.�.. A�� � �%[,� i <br />'�� <br />TENANTNAME <br />ceNtrucroa �m��Q , <br />CONTR. UCEN�9E P.�`��L�. /D/� <br />� ���0-U <br />USE OF BUILOING <br />WORK U SCc F R�PT�O� � /� �l 1 <br />!/ ., �.'- rr,:`"I <br />[�lJLe <br />PLUMBING <br />N0. I TYPE OF FIXTURE OR ITEM <br />� Toilet <br />�Bethtub <br />Levatory (wesh basin) <br />� Shower <br />� Kitchen sink 8 disposel <br />� Dishweshar <br />Clothes wasfier <br />Laundry trey <br />Sink (servicelberlmopletc.j <br />Beckflow preventer <br />L Urinel <br />Drinking Founlein <br />floor drein <br />� Grease trap <br />Roof drelns <br />Other <br />TRACT <br />PARCEL TAX I.D, q <br />�/C/E'r/o2 <br />I GONTA�R P� <br />� <br />pD�RE8S CITYRIP �' r N�� <br />� �-' <br />95�� 5`� �L/�/Oz, �iz.��'�r/�' <br />`�!� jJ PHONE <br />HEA"f SOURCE <br />Electric ✓ cies _ Other <br />'/ y17o <br />• /5�70 <br />�IQ— <br />CONTRACT PRICE 7F WORK <br />NO. I TYPE OF FIX'NRE Oft fTEM <br />AIC — alr hendling units <br />LForced elr systems <br />Ges pfping <br />L, Weler healer <br />1 Ges fireplece <br />L Ges renge <br />1 Clolhes dryer <br />__!_ Renge hood <br />�1- Exheusllen <br />_� Heet pump <br />Unit healer <br />"` Boiler <br />� Refrigeretion <br />Woodstove <br />01her_�— <br />------ <br />CITY OF EVERETT LOCAL 8ALE8 TAX CODE 19 �10b <br />1 heraby ceriUfy Ihel I heve read and exemined thia epplicetion end know lhe seme to be lrua and cottect. All provislons of lews end <br />ordineces goveming lhls typa of work will be complied wilh whather spedhed hereln or not. The grenting ot a pe ��B �� presume <br />to glve authority to violete or cancel Iho provislon of eny other stete or lacal law reguletlng construcUon o� 1he pe y��h lha <br />construdion. 7het I am authorized by the owner of thls property to per(orm the work tor which eppllcaUon Is mede end I comply <br />Slete Contrectors Lew_1?.27 RCW end 286.200 WAC. � � <br />