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SITE 6+DDRE3 <br />�A LOTNO. <br />DESC.� <br />OW/NlER <br />�4'c.O/�// <br />TENANTNPME <br />USE OF BUILDING <br />PERMIT APPLICRTION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEI", EVERETT, WA 99201 <br />425-257-8810 — FAX 425457-8857 — www.everettwa.org <br />APPUCATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />BI �CK <br />� /'rafr�- <br />WORK �ESCRIPTION <br />PLUMBING <br />NO. I TYPE OF FIXTURE nR ITEM <br />Toilet ' <br />Oathtub <br />Lavatory (wash basin) <br />� Shower <br />� Kitchen sink 6 dispasal <br />Oishwasl�er <br />Clothes washer <br />Wator heater <br />Sink (scrvirx/be�ltnopletc.) <br />Onckflow preveMer <br />� Urinal <br />Dnnking Founlain <br />F�oor draia <br />Grease trap <br />Foof drains <br />OUier _ <br />PARCEL TAX I.O. M <br />TRACT OR SUBOMSION A <br />FOR PER611T <br />�� <br />HEA7 SOURC;E <br />EleCtric _ Gas _, Oth3r <br />�/ - � -�d <br />CONTRACT PRICE OF WORK <br />� �'/�� � //! / <br />NO. I 7YPE Uf FIXTURE OR ITEM <br />A/C — air hantlling urils <br />Fnrced air systems <br />Gas pipinp <br />Water heater <br />Gas fireplace <br />OasrRngo <br />C�oth� tlryer <br />Range hood <br />Exhaustfan <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />CITV OF EVBRETT LDCAL SM.ES 7AX CODE IS 1106 <br />� I hereby CRrtify ihal I hev0 fead and ex0lnlned fhis epplicalion and knowthe same t0 6e true and cort'aG. All pmvisions of laws and <br />I ordinances goveming this type oi work will be complied with wbcther spedfied herein or not. The granting of a pemiit does not presume <br />to gWe authonty to vlolate or cancnl lhe provision of any other slate or local law regulating canstructlon or tne pertormance of <br />iConSIrUUion. That I am aulhorized by ihe owner of this property !o perfortn ihe work tor whiCh appliratirn i3 mada and I Comply with the <br />Stale Cot�tradors Lawyq27 RGW and 296.200 WAC. , , <br />