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SITE ADDRESS <br />LEGAL LOT O. ^ <br />DESC. �� � � � bs <br />, �zfl1KMG�(`(e <br />��RMIT APPLICATi(�N <br />CITY OF EVERETT PERMIT SERViCE�, <br />32UG CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APRLICATIONS ARE ACCEPTED FROM 8 AM TC 4 PM <br />PARCEL TAX I.D. # <br />BLOCK � TRACT OR SUBOIVISION # <br />TENANT NAME CONTACT FOR PER�dIT <br />� (��czS� lpr�i��7iPs I -�ec� %��, ilc� <br />CONTRACTOR �^_. _ �� � _ � �R��� l�� �� <br />z��t�c/ l�eaF,�r ,/�L' tk <br />CONTR. LICENSE #�Q�n"y' N�� t� I�/' � <br />u <br />USE OF BUILDING <br />WORK DESCRIPTION <br />�7,'C'C,v (',`1 L(,_ -{- �'X 1-cx�1 <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/badmop/elcJ <br />6ackflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />Eleclric _ Gas _ Olher <br />� <br />PERMIT # <br />-C2 <br />PHONE <br />aS3- 6�6- ��t��l <br />x s3 g�5:335'v <br />wA. <br />CONTRACT PRICE OF WORK <br />�ti <br />u�t <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems � � <br />Gas piping i �`� �,� <br />Walerheater ° ^ <br />Gas tireplace � f�`� ;� Q <br />Gas range � ,� J' <br />Clothes dryer � <br />Range hood � ��� � <br />Exhaustfan ������ � <br />Heat pump � <br />Umt heater <br />Boiler <br />Re(rigeralion <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriti(y lhat I have read and examined this applicalion and know the same to be lrue and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied wilh whelher specitied herein or not. The granting of a permit does not presume <br />to give authority lo violate or cancel lhe provision o( any other state or local law reyula!ing construclion or the pertormance of <br />construclion. That I am aulhorized by ihe owner of this property to perform the work (or which applic2lion is made and I comply with the <br />Slate Contraclors Law ;8.27 RCW and 296.200 WAC. � � <br />/C�i%� /G: <br />