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SITE ADDRESS <br />PL. tMIT APPLICATIOf _ <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />42&257-8810 — FAX 425-257••8857 — www.evereriwa.org <br />APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� G�X� �L� <br />PARCEL Th% I.D, N PERMIT * <br />�Imor�l.ana�� , �,,r.< <<- <br />LOTNO. �/] � BLOCK � TRACT <br />TENANT NAME <br />��(!E f/oz <br />ICONTACT FOR PERMIT PHONE <br />�rP.�"�2La !/�h eJ �FzS-7s�/ - <br />CON7RACTOR L. /1m��Q � �DREBS " CITYRIP PMON <br />.(>e.t' /� [t �^�r-� �,��� y�?.� - � <br />coNrn.uceNBc� n�T�IL_�s2l�0 7v'r/� 7 �`/iiC �OZj �i�L�1�L/l+d' <br />Q <br />USE OF BUILDING <br />WORK D SC� RIPTION � O <br />�[���� e� Z � <br />N�. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bethtub <br />Levetory (wesh bnsin) <br />Shower <br />Kilchen sink 8 dispasal <br />Dishwesher <br />Clolhas wasfier <br />Leundry tray <br />Sink (servicoPoadmopletc.) <br />Beckflow preventer <br />Urinel <br />Dnnking Fountein <br />Floor drein <br />Greasotrep <br />Rooi drains <br />Other . __ <br />L(/��-- <br />— HEAT SOURCE I CONTRACT PRICE OF WORK <br />Eledric ✓ Ges Other <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — air hand�ing unfls <br />�Forced eir systems <br />, Ges pping <br />L, Water heater <br />,L Ges fireplece <br />,� Ges renge <br />J_ Clothes dryer <br />_.L Rengehood <br />�yL Exhaust fan <br />_ Heet pump <br />� Unll heater <br />—" Boller <br />� Refrigerelion <br />Woodstove <br />_ Other�_ <br />C17Y OF EVERETT LOCAI 9ALE8 TA% CODE 19 ]106 <br />I hereby ceritily that I heve read end exomined this apptication end know lhe seme to be lrue end cottect. All provlslons o( lews end <br />ordinaces goveming this type ol work vnll be c�mplied with whelher apedfied herein or not. The grenling ol a pertnll does not presume <br />to give euthonty to vioiate or cancel lhe provislon oi eny other stele or local law reguletlnp construclfon or the pedormance ot �th the <br />constructioa Thel I em authonzed by the ownar ol this property ro peAorm the work lor which appllcetion Is made end I comply <br />State Cantractors Lew 18.27 RCW end 286.200 WAC. , <br />