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��RMIT APPLICATI.�N <br />CITY OF EVERETT PERMlT SERVIGES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />a25-257-8810 - FAX 425-257-8857 - �vww.everettwa.org <br />APPLI NS ARE ACCEPTFD FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADURES PARCEL TAX I.D. k ' PE I il <br />632 S,�BdEc:s� A�✓E I �j�(�Z-� <br />LEGA� LOTNO. BLOCK TRACT <br />C�rs T•+�fc.v2 �03�8 6t'�'/ �v� �� <br />TENANT NAME I CONTACT FOR PERMIT <br />CONTRACTOR ����ySON P�-�1'1(�• ADDRESS CITY2IP <br />�A33o ia-�fni .Lv� NF <br />CONTR. LICENSF p ROd�.vro.k� t-� uy <br />USE OF BUILDING <br />S GR � DA�,.GoR� <br />WORK DESCRIPTION <br />/�vG T�4tc fti R� <br />PHONE <br />PHONE�� � ��Z <br />ARt�,�.!✓u../ . 4Pt�-7 <br />I -- HEAT SOURCE <br />Electric Gas Other <br />SFR+.'.�.GckrtS /N N�✓ <br />N0. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 di�posal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (servicolbadmop/etc.) <br />Backflow prevenler <br />Urinal <br />Dnnking Fountain <br />Floor drain <br />Groase trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />�`�goo <br />+4r�Dr rie..� <br />MECHANICAL <br />NO. I TYPE Of� FIXTURE OR ITEM <br />A/G — air hantlling uN;s <br />Forced air systems <br />Gas piping <br />W aler heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhatist fan <br />Fieat pump <br />Unit healer <br />Boiler <br />Re(rigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7103 <br />I hareby ceritity that I ha��e read and oxamined this applica6�n and know the same ;o be true and correct. All provisions of laws and <br />ordinaces govemmg this rype of work will Ge complied with whether specified herein or not. The granting of a pertnit does not presume <br />to grve aulhonty to violate or cancel the provision of any other stale or local law regulaUng constructlon or the peAormance of <br />r.onstruction. That I em authorized by the owner of this property to peAorm the work for which applicaUon is made and I comply wilh the <br />S!ate Contrecrors Lay418.Z;;R�'✓V and 29E.200 WAC. <br />��Z <br />