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SITE <br />tess /S <br />'yrn. Gr. <br />LOT NO. <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 �._� 7�� <br />ccJ .��.ra� . <br />w� <br />BLOCK <br />�Tj�ENANTNAME �� /% <br />��td�/i+4 ��7'�{LTlO� C...K.fC� <br />%Y%Ef �'E/L <br />CONTR. LICENSE # <br />% �.LC <br />�{r.�v-rn� T�C'• <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION # <br />CONTACT FOR PERMIT <br />1'7.w,v7 �.�av� G✓'9 `�$.4 %3 <br />hiFy'F�e y � �sir�Ys <br />USE OF BUILUING <br />.�i� E/y C� L �/%C� <br />WORK DESCRIPTION <br />ryr, � TYpE OF FIXTURE OR IT[M <br />Toilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />Backfiow preven�er <br />U� inal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other _ <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />PERMIT # <br />'� 10op- <br />PHONE .3F+c� — �iQ �j/—Gi8'1I <br />7�ir/� 27 �tXr <br />E-MAIL ��¢{i,L�•�. ('e++�^� <br />PF�OTJE <br />3�0�/02 f/��87�? <br />CONTRACT PRICE OF WORK <br />L�• <br />/i • <br />N0. I TYPE OF FIXTURE OR ITEM <br />_ A/C — air handling units 3 <br />_ Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />�Range hood <br />Exhaust fan <br />Hea� pump <br />Unit heater <br />8oiler <br />Refrigeralion , <br />Woods�ove <br />Other�� 4 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify Ihat I have, read and examined !��is applicalion and know the same to be true and correct. All provisions of laws and <br />ordinances governin� th�s type of work �Nill te complied wilh whether specified herein or not The �ranting of a permil does not presume <br />to give authority to violat� or cance� ine provision of any other sta�e or local law regulating construr.lion or the performance o( <br />construclion. Th< t-! em aulh d by the owner of ihis property to perform the work forwhich application is made and I comply wilh �he <br />Sla�e Conlr�ys-J;eGv 18. RCW and 296.200 WAC. � � <br />,7_ ��/J <br />1I <br />Z <br />