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SITE ADDRESS <br />`� 7.�. ��1�� <br />LEGA LOTNO. <br />DESC. L��� J �{ S <br />�� ��;�\, r���, <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 ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. M <br />-��,z«9�a�1 �oyq6��3eo����c�c <br />BLOCK TRACT OR ^SUBDIVISION k <br />� 17•O(\ �ev-,o. Yc,t�• <br />� <br />PERMIT <br />��a�\ <br />PHONE <br />ITRACTOR AOORESS � w nur <br />c,��;,hq+co. ��Ttv„\ G�.s, �G�r w.C�,s,n� �Z�'�1c, 53��,04 <br />RR. LICENSE t _ _ _ � <br />USE OF BUILD�NG <br />`\Z�s.��ri.�� ��nvne <br />WORK DESCRIPTION �l � �;l <br />1� t� <br />��Cl��< < <br />I — HEAT SOURCE <br />Electric � Gas _ Olher <br />; ( � � �.,A\ �. �, �.J ��t� r \� a c,� c f <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BalhWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Cbthes washer <br />Water heater <br />Sink (service/badmopletc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olhcr <br />1�-- �o -ro <br />�ERMlzk/� —� <br />�// <br />IONE <br />�1-3�.� -3�-� 3 <br />faR� <br />�.5' 3��1' ��1��' <br />CONTRACT PRICE OF WORK <br />�, `l�s��o <br />��� �U C�,\\�,,�.��te, - <br />N0. I TYPE OF FIXTURE OR ITEM <br />NC — air handling units <br />Forced air systems <br />Gaa piping <br />Waler healer <br />Gas freplace <br />Gasrango <br />Clothes dryer <br />Rango hood <br />Exhaust tan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstova <br />Olher <br />CITY OF EVERETT LOCILL SALES 7AX CODE IS J705 <br />I hereby certify that I have read and ezamined this application and know the same to be truo and correcl. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or noL The granting of a permit does not presume <br />lo give authonry lo violato or cancel the provision of any olher stale or local law regulaling construction or the pedormance of <br />conslruction. That I am authorized by tho owner o( Mis property to per(orm the work for which application is made and I comply vnth the <br />Stato Contrectors Law 18.2Z 8� �d21G200 WAC. � � <br />�311r> <br />