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SITE <br />P�RMIT 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 />� <br />iES PARCEL TAX I.D.1 P I <br />� n� � ' �00_�1 y�ai�/��� 9a� � �,�D-3C��v <br />LOTNO. OCK TRACTORSUBdNS10Nil <br />TENANTNAME <br />N/A <br />CONTACT FOR P�RMIT <br />MaQy FEaeS <br />4V1\ �l�NY 1 VA <br />ah �%-1 �t �-� um�n, <br />CONTIi. LICENSE M N IA <br />USE OF BUILDING I <br />WORK DESCRIPTION <br />� Ke�oFa i �h� �oMES <br />S - 3Eoa���i <br />NO. I 7VPE OF FlXiLRE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />shower (�j - R Ea 'Loo+-t N�ME� <br />Kitchen sink 8 disposal �C N NdME <br />Dishwasl�er <br />Clothos washer <br />Water heater <br />Sink (serviceh�ar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Aoo1 drains <br />Other <br />ui rrzif <br />Snohom�sh C'�iun7� <br />� . � <br />Q�-�"�'rJ$� <br />Mit�se. �,'�t4 <br />HEATSOURCE I CONTRACTPRICEOFWORK <br />�C Electri��,� Gas _ Other <br />Cmus�eu�� �oN , �3- H�c �G�P.��� �j �_ <br />N0. I TYPE OF flIITUHE OR ITEM <br />A/C — air handling i <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust lan <br />Heat pump <br />Unit hoater <br />Boiler <br />Refrigeration <br />Woodstove <br />CfTY OF EVERETT LOCAL SALES TAX CODE IS 0105 <br />I hereby ceritify tlial I havo raud and oxaminod lhis applicatlon and know Ihe samo lo be lruo and correcl. All provislons of laws and <br />ordinaces govemfng this type oi woric will be complied with whether speclfied herein or not. The gran6ng ol a pettnit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulaNng construcHon or the performance of <br />construction. That I am aulhorized by the owner ol this property to pertorm the work for xAiich applicallon is made and I comply wilh Iho <br />State Contractors Law 18.27 RCW and 296.200 WAC. i <br />.� <br />