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SITE ADDRESS <br />LOT N0. <br />- , <br />'�r%i /��i- <br />TENANTNAME <br />P" �RMIT APPLICATI(' y <br />CITY OF EVERETf 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 />BLOCK <br />_ , ', '� <br />PARCEL TAX I.D. � <br />TRACT OR SUBDIVISION p <br />ADDRESS <br />�l�i�'. ;'� .;�,i���,��,� � ti <br />CONTACT FOR PERMIT � <br />�� ��t <br />��I <br />\-�v�'.St��� 1-liA'cNc_�I\N��i�i,«�e�(� ].�� <br />CONTR. LICENSE i� <br />USE OF BUILDING <br />�:�cl�k:� 1����y:i�S <br />' �V V C V�CI�u�.i <br />C <br />�. L:.�-: . � � �. � _ � ,.�1 N"e i � <br />.� i <br />FIEAT SOURCE <br />Electric � Gas _ <br />Olher <br />%%, 'J <br />/'r'09G2 —or?(o <br />PERMIT q <br />::: �_:c-`-- <br />( Ji•� ' ` C �J -j �� <br />ZC76 —`/ ��1- S Z Z'] <br />�.�:.4 L'.�._,c� C�c,c'tr. <br />C'qJ <br />� /� Cc�� .-y�� �'�1 C: ] =-�;i <br />CONTRACT PRICE OF WORK <br />�i� ���, Cc,�, - <br />WORK DESCRIPTION <br />-i:1��-_lr_q\ .`-) r�s_,'.-- \L�> , ���ii� c��ri-�1�1..1 � 1H1'-:\�n1 l ;''.h0.i.��t ';``�i-e��l <br />N0. I TVPE OF FlXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />W ater heater <br />Sink (service/bar/mop/etc.) <br />Backllow preven[er <br />Urinal <br />Drinking Fountain <br />Floor drain <br />_ Greasetrap <br />Roo� drains <br />_ Other <br />NO. I TYPE OF FIXTURE OR fTEM <br />A/C - air handling units <br />=�. �orced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />_ Clothes dryer <br />Range hood <br />_� Exhaustfan <br />Heat pump <br />Unit heater <br />Hoiler <br />Relrigera;ion <br />Woodstove <br />1 Ofher bir �����'� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />c,rdii�aces governing this type of work will be complied with whetlier specitied herein or not. The granting ot a permit does not presuma <br />to give authoriry to violate or cancei the provision of any other state or local law regulatlng construction or the perfortnance of <br />construction. That I am authorized by the o�mer of this property to perform the work lor which application is made and 1 comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />—_= � , �_ � '�/G'/' `% <br />