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PERMIT APPLICATION <br />CITY OF EVERETT PERh11T SERVECES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />SITE ADDflESS <br />�223 ����.�-,��d <br />LEGA LOT NO. <br />DESC. <br />� <br />TENANT NAME <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D.1t <br />TRACT OR SUBDIVISION p <br />CONTACTFORPERMIT <br />PHONE <br />PERMIT ft <br />�1,r�a- o � o <br />�k'-� b L- E G� A`t 5 I e�a� <br />�— <br />,�t7/3in%J�'ni /�Lunvi3.n�G l3bd%Yo3� �YG; <br />CONTR. IICENSE # � `73�U �� ��"� Q �` '�� <br />/1,�[i.vC ,-�N <br />USE OF BUILDING <br />WORK DESCRIPTION <br />in.'sT�acc F�12i <br />HEATSOURCE <br />Eleclric Gas Olher <br />CONTRACT PRICE OF WORK <br />� � s�z� <br />S�iZi��Kcc-32 S`YSTz=>i.9 /�C�t-' Ni= ��A /.3� <br />NO. � TYPE OF FIXTUfiE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Sltower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicePoar/moplelc.) <br />8ackllow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greaso trap <br />Rool drains <br />Other <br />N0. I TYPE OF FIXTUHE OR ITEM <br />{VC - air handling units <br />Forced air syslems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />ExhausUan <br />Heat pump <br />Unit heater <br />Boiler <br />Retrigeration <br />Woadstove <br />S/��A'-�n-�lLc ���Lr�i�7S <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />I hereby ceritily ihal I have read and examined this application and know the same to be irue and correct. All provisions of laws and <br />ordinaces goveming ihis type oi work will be complied with whether specilied herein or nol. The granting ol a permit does not presume <br />to give authority !o violate or cancel the provision ol any other slato cr local law regulating consimclion or the pedormance of <br />construction. That I am au�horized b the owner of Ihis property to perlorm ihe work 1or which application is made and I comply with the <br />State Conirector, Law 1827 RC an 296200 WAC. <br />'/Z <br />