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F'�rZMIT AP�PL.ICATI(� .� <br />:�� =:9TY �F EVERETT F'FRMIT SERV:��S <br />3G00 CEDAR STREET, EVER[Tf, WA 98201 <br />47_5-257-8810 — FAX 425-257-8857 — www.everetiwa.org <br />-�s-3i-Y— � <br />I <br />APPLICATIONS ,"vR� ;\CCEPTE�) FROM 8 AM TO 4 PM - DEBIT & CR[�IT CARD7 ARE NOT ACCEPTED <br />SITE AD�RESS PARCEL TAX I.D. t: PERMIT # <br />'� 7a t1.�..,� �,io,.., , r�. nn �°I 2Sooc'7�Zcx�o I CGSr�-k-G 4 <br />"l:.>ii LUT NO. �LOCI( TRACT <br />c�C . <br />C';:�tiEn . . . — _.--_—__ —_ _ AO[1RG5:' <br />�ish v_�`��I-�s ���--- <br />T`cNANT NAh'� i CONTACT POR PERLiIT <br />cTe�� I�.�e --- ��T��1.�,_e <br />eonTancro�. J <br />fiShbY�"' I.{�. LLL <br />:;ONTR. LICENSE �' <br />�a i t _y5.�� 5"-- <br />USE OF QUILDIMG <br />�Z_�_ I��14� <br />�.voPt: oesrr,ir�Tio�, <br />� <br />noortess � <br />_y5ly 4r''�i.�lE �.,,4� Iv_� <br />H[AT SOURCE <br />_ Eleclric �1Gas _ Olher <br />_. T , \ <br />;i0. � ll'P[OFfIXIUR[ORIT�M1I <br />_3_i ��'� ;x2= b <br />__�_i 6ath;ui�x2cZ <br />-�-� L_rvaior: ��::2sh h.isu�)�c2 =8 <br />_� cho,.or x 2 a2 <br />Kit�in:n sinl. c= disp�.�snl x 2: Z <br />�_ Dishwashar x 2�= 2 <br />� Clolhes washer %Z = Z <br />Laundry tray <br />Sink (servicelbadmrplcic:.) <br />� BacFilow pre�renter x I = � <br />Urinal <br />D�inking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. <br />1'HONE <br />CI1Y21P PI'ONE <br />4�- 75 v-3aa r _ <br />CONTRACT PRICE OF WORI< <br />�vr� or- r-ixTUR� oa ire�.� <br />rVC - air handling unifs <br />Forced air syslems x Z= 2 <br />Gas pipinc� x 2 =b <br />Water healer x 2= 2 <br />Ga� �replace �c 2 =� <br />Gas rang�� <br />Clolhe� Jryer x 2 =2 <br />Ranqe huod x Z� 2 <br />cxhaust tan x 2= (� <br />Heat pump <br />Unil heater <br />Bo(ler <br />ReFrigeration <br />Woodstovo <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />hereby ceritify that I have read and examined this application and know the same to be lrue and correct. Ail provisions oF laws and <br />crdinaces gov�ming this type of work will be complled wilh whether specified herein or �ot. The granlin� of a pemiil does not presume <br />o pive aulhoriry to violale or cancel thu provisi, n of any olher stale or local la�v re9ulatinr� r.onstrucliun or tlie pertormanr.e o( <br />cnstruction. Tiiat I am authorized by the ownoroF this propr.rty lo peAorm lh� �•:orl: (or r;l:ir.h .ipplic�lion is m:id�� and I com��l, with Ihe <br />;• � Contractnr; La�.v 1�.27 RGW and 29fi2D0 WAC. <br />i� <br />L <br />