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�ITE ADDRESS <br />�izz7i <br />LEGAL LOT NO. <br />DESC. <br />�� � <br />TENANT Ni <br />.� — <br />'PERMIT 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 ACCEP7ED FROM 8 AM TO 4 PM <br />5 <br />� <br />�d �' I PARCEL TAX I.D. # <br />s::�,'�� rYv?qc, .z�r.c�.. <br />CONTR.UCENSEp <br />USE OF BUIL�iING `� <br />� <br />TRACT OR SUBDiVISION N <br />CONTACT FOR PERMIT <br />PHONE <br />PERMlT # <br />��10� n I- caa <br />�1�1� �Z � �l�`s7�c,�..,,. ¢�.s: sD� <br />j� :s—� �`; g� <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />� le�tric �s __ Olher -� �; �� <br />WORK DESCRIPTION ���y� S_,� i �� /�r� L <br />�G(�f �h �jC%t'��i� � C �i [ `iJ d� / Qr�r�y Z ' <br />G��� l�-l��G�.G� t3�liC.�'tG�dZ��� � % • �� <br />��ti � _ � <br />� <br />� <br />TYP[ OF FI%TURE OR ITEM <br />Toilet <br />BathWb <br />Lavalury (wash basin) <br />Showcr <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />O�her <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping 3 �(��{$ <br />Water heater <br />Gas tireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Ezhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Relrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify lhat I have read and eRamined lhis applicalion and know the same to be true and correcl. All provisions of laws and <br />ordinaces goveming lhis type of work will be complied with whelher specitied herein or not. The granting ot a permit does not presume <br />lo yive aulhorily lo violate or cancel the provision of any other stale or local law regulai�ng construction or the performance of <br />construclion. That I am aulhorized by the owner of lhis properly lo per(orm the work for which application is made and I comply wilh lhe <br />Stale Coniractors Law 10.27 RCW and 256.200 WAC. <br />�sx;� / - l3 — C%� <br />ent Dale �I <br />l� <br />