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SITE ADDRESS <br />�725 '�c� <br />LEGAL LOTt�O. <br />PERMIT APPLICATIO�1 <br />CITY OF EVERETT PERMIT S�ERVICES <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 />W <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION # <br />�11� �TS �� �H.c.i.1�1 i��. i.�� <br />TENANT NAME � CONTACT I OR PERMIT <br />CONTR. LICENSE # <br />USE OF BUILDING <br />�-O L`�Slll..�i 6J nuune�a ••���,��� <br />lSRp� tJE �orh �U� '�-,,oG��� <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />PERMIT # <br />i!'(� 0� • l% � �Z <br />_L.� � 6�.�� <br />5 - «zs <br />��..1G2) <br />?��f1✓LTIOh • l�J� <br />E <br />�) 5�4b—�6z_5 <br />CONTRACT PRICE OF WORK <br />�u <br />� <br />� �� �pJ <br />WORKDESCRIPTION"��NJ/�T /M�Dj7vY����'r N�"`� UG�^�G� ��tor2�NG <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />BalhWb <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwashar <br />Clothes washer <br />Waler hea�er <br />Sink (serviceNadmop/elc.) <br />Back(low preventer <br />Urinal <br />DrinY,ing Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A,�C — air handling units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gasrange <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />OfhP.f <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this applicalion and know the same to be lrue and correcl. All provisions o( la�vs and <br />ordinaces goveming this type of work will be complied ���ith whelher specified herein or nol The grantiny of a permit does not presume <br />to give aulhority to violale or cancel the provision of any olher slate or local law regulating wnstructicn or the performance of <br />conslruc'on. That I am aulhorized by the owner o( this property lo pedorm the work tor which ap�licalion is made and I comply with lhe <br />State o tractors La� 18.27 RCW and 296.200 WAC. <br />Signalu�e o� OwnedC rdractodAuthorized Ac�enl `���� <br />�C <br />