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SITE ADDRESS � <br />EV-eV�2�+ <br />LEGA LOT NO. <br />�FSr_ �"of Ig <br />na <br />�ERMIT APPLICATI�N <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 />">"y.10 �-QcYvte�.c7 <br />, nJ �1 q$ 203 <br />BLOCK <br />� �1 <br />--•••U`-� J,•�,/ <br />CO�iTR. LICENSE N <br />USE OF BUILDING <br />1�2S�dence�, S�i�U�� rnNt <br />PARCEL TAX I.D. 8 <br />Gb4�-�c�oc <br />�CT OR SUBDIVISION • <br />CONTACT FOR PERMIT <br />�'ame, <br />S�r�YP/ <br />HEATSOURCE <br />Electric �C Gas _ Olher <br />WORK DESCRIPTION . . • <br />�(,�. j�QYv�cr.ie l Qvd- Gt dd �fT o n-ta ,2�� s+-i rg ho m2. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub � <br />Lavatory (wa5h basin) <br />Showei"�.:� 7 ✓ �I <br />Kitchen sink & disposai <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backllow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap __ <br />Roof drains � _ <br />� r���/Z�� <br />>> o n t�l� . 2 <br />PHONE <br />4?� 34� ��1833 hm <br />�03 425 35�1•�0`�7� ceU <br />PHONE <br />E-MAIL qCAGIv� i � comtust�.nel <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR 17EM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas (ireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heatpump —/�J.U��(j/�. <br />Unit he3ler <br />Boiler <br />CITV OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />....pl%.�'j "i���:l� <br />1 hereby ceritify that I have read and examined ihis application and know the same to be true and correct. All provisions oi laws and <br />ordinaces governing ihis lype of work will be compiied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the peAormance of <br />construction. That I am authorized by the owner of this property to perform ihe work tor which application is made and I comply with the <br />Slate Contractors Law 18.27 RCW and 296.200 WAC. <br />�� .�;>>- 'n _ �r �._ i ; !1 , ; !% <br />��2 <br />