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( <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.evere'lwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />F3ti�177;I��7 <br />LOT N0. I BLOCN <br />u 3J isrn2�-F� m Ec N.�L <br />CONTR. LICENSE N <br />Ux��rn�/o93� <br />USE OF BUILDING <br />PARCEL TAX I.D. N � <br />, �8�5 � �o0 30 3zo � <br />TRACT OR 3UBDIV1910N � <br />Ze�2 p,�Q�Ev AR. <br />CONTACT FOR PERMIT <br />EUEKE'i'T <br />uNezm.�rEn mF�N. �N� <br />PERMIT N <br />�IUI G <br />MONE � <br />-� vo3 <br />PHONE'J�6� 9'�3- <br />..--��--- -.. _. <br />P.o. BoX 14r7 ma,evsvzcc� 9B.z�b <br />�j(. �' �3— �� <br />HEATSOURCE <br />_ Electrlc _ Gae _ Other <br />WORK DESCRIPTION <br />A�.1f� 3# SPQzn�IC�ER NEA/J <br />NO. I TYPE OF FIXTURE OR ITEIN <br />Toilet <br />Balhtub <br />Levalory (wash besin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes waeher <br />Waler healer <br />Sink (servlrn/barlmop/elc.) <br />Backllow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greese trep <br />Rool draine <br />Other <br />N0. <br />�(�b) <br />°!�3-0�8� <br />COHTRACT PRICE OF WORK <br />900 °° <br />TYPE OF FIXTURE OR ITEM <br />A/C — afr handling unils <br />Forced aIr systems <br />Gea piping <br />Weler heater <br />Ges flreplace <br />Ges range <br />Clothes dryer <br />Ranpehood <br />Exhauat fen <br />Heat pump <br />Unil heater <br />Boiler <br />Relrigarelion <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES TAK CODE IS 7106 <br />I hereby certily that I have read end examined this application and know Ihe seme lo be Irue end corred. All provfe�ona ot lews and <br />ordinances governinp Ihis lype ol work will be complied with whelher specified herein or nol. The pranting o1 e permit doea not preaume <br />to give eutl�ority to vidale or cancel the provision o( eny other state or local law regulating conatruction or the peAormanoe ol <br />construction. That I em authorized by the owner of this propeAy to pertortn ihe work 1or whlch rpplicalion is made and I comply wflh lhe <br />Slele onlractors Lew 18.27 RCW and 298.200 WAC. <br />��,,.,,_ � .��.�...,,..�> 9l7/,0 <br />. <br />