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CC".2l"�.200? ;:45F41 SD DERCON <br />N0.1390 r^. 2� <br />i� <br />PEaMIT APPLICATION <br />Ci1'Y OF EVERETT pERMIT SERVICES <br />3200 CEDAR STREET, EVERER� VyA 98201 <br />425-257-8810 - FAX 425-267-6857 - y,�y�y,everettwe.org <br />APPLICATIONS ARE ACC2PTEp FROM 8 AM TO 4 PM - DEBIT & CREDIT CpRDS AR� NOT ACCEp�p <br />SITE ADDRFBS I PARCEL TA7( I.D. # � PlRMIT E <br />/3oa �s �„�,,.-.. na. . , <br />' ' �'lu?[y7 <br />='LL��::lli� <br />S� r7L�X on� Coe O a� Ccl zi <br />coNifz ucENSE _ <br />USE OF BJILDING <br />6�9��•�r <br />WORK DESCRIPTION <br />�X�'JOL> non] <br />No. � mee oF �cnir� ae rtrxt <br />Ba1Mub <br />Lavatory (vrash basin) <br />Shower <br />Krtehen sink 6 disposal <br />Dishwashar <br />Clothes washer <br />Laundry frey <br />Sink (servioe/bedmop/eta) <br />BadAlow prevenMr <br />Urinai <br />DrinMng Fountain <br />Floordrain <br />Greasa trap <br />Raof dralns <br />Other <br />AooReSS — <br />a37s' i3o*�,�v�i✓C-" <br />rjwfe� �pL1 <br />t�ArsauRCe <br />_Deario _ces,uu�er <br />l0 -OUS <br />�',ce S'z6- �By Hceo <br />crtvinP PHONe -- <br />�tC.�i/uff� W,"� '/�6.28H-5'aw <br />CONiRqCT PRICE OF Wqq►( <br />NPE OF FIXNRE OR REM <br />i AIC—alrhandlirtq units <br />Farced eirsysfems <br />Gas pipi�g <br />Wahr heater <br />Gas nreplace <br />Gas ranye <br />Cothes dryer <br />Fiange hood <br />�chausi tan <br />Hest pump <br />Urdtheeter <br />BoOer <br />Rofrigeratlon <br />Woodsrova <br />Other <br />CITY O' EVERETT LACAL SALES TAX COpE IS NOS <br />I hereby cert�tify tAat 1 hev� read and ezamhied this appfication ar�d lmoW }he same to be true and correa, qp provicions of lews and <br />ordinaces goveming this type of work vrill be mmplied wfth whether s�dfied �In or not Tho granting of a pertnft docs not prcsumQ <br />tn give authority to violate or cancel the provision of arry other state or local law regulating ronstruction ar tha performana oi <br />consWction. That I am authorize by the awner ot thls p�opetry ta per(orm me Wp�k farvrhich applicatian is made and I comD�Y �fh the <br />State Co�adors Lew 18.27 �l and 288.200 WAC. <br />