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P�.�1MIT APPLICATI��� <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />6��E.r <br />LEGA LOT N0. <br />DESC. <br />F✓�T, w.j <br />BLOCK <br />TRACT <br />PARCEL TAX I.D. # <br />OWNER AOUFE55 GITY2IP PMONE jf2s— <br />�/tnl I'FR/1F1� ..fo�3 E. C�PE'1'T F�E,2C�LvA. 9k2a3 s.T2g3S`9 <br />TENANT NAME I CUNTAC7 FOR PERMIT PHONE <br />CONTRACTOR S�t,� <br />CONTR. LICENSE # <br />l' - <br />USE OF BUILDING <br />WORK DESCRIPTION <br />1 /%l £d ,v�'jyLU <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbar/mop/etc.) <br />Backilow preventer <br />Urinal <br />Drinking Fountain <br />Fioor drain <br />Grease trap <br />Roof drains <br />Other <br />ADDRESS � e y 2 �_2, r r C�TY21P PHONE /yc 1j — <br />dR. <br />E'v <br />Zog� ��767G� <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Eiectric Gas Other <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — aIr handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />E�chaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby ceritify that t have read ard examined this application and know the same to be true and correct. Ail provisions of laws and <br />ordinaces governing this type of work will be complied wilh whether specified herein or not. The granting of a pertnit does not presume <br />to give authority to violate or cancel the provision of any other state or local �aw regulating construction or the performance of <br />construction. That I am authorized by the owner f this preperty to perform the work for which application is made and I comply with the <br />State Co � w 18. '��a��.� AC. 26 6�T6'�i� <br />