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PC..MIT APPLICATIO�. <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 <br />SITE ADDRESS �� l �� <br />i a 1 sE e�p .e �� /�Gl/Lri<t <br />LOT NO. <br />DFSC. j � I <br />OWNER / � <br />v;ry%/s«��- <br />BLOCK <br />� Z <br />TENANT( NAME <br />%1'�W�U�7unJ 10�t^.1z�� <br />P�LU/Y1rr-��G' <br />CONTR. LICENSE I! n�S C U G I <br />,� <br />USE OF BUILDING <br />�U�d�/i�y (i���� <br />WORK DESCRIPTION <br />�Li <br />K <br />PARCEL TAX I.D. p <br />TRACT OR SUBDIVISION # <br />� ,� J b' � � <br />:ONTACT FOR PERMIT <br />�, ��.-� L ci r.!` r r� <br />DRE S <br />,P o . �vx � 6 <br />M <br />HEATSOURCE <br />S� w <br />� <br />7 S3/22�,—Z <br />G� /� S'�--� <br />ti �sass <br />�lectric _Gas_Other <br />�� <br />NO. � TYPE OF FIXTURE OR IT[M <br />Toilet <br />Bathlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mopletc.) <br />_ 13ackllow preventer <br />Jrinal <br />� Drinkinc� Fountain <br />Floor drain <br />Greasetrap <br />Roof drains <br />OU,er <br />���/ <br />�/�- �so� <br />�ONTRACT PRICE OF WORK <br />�SUp � <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />qothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby certify that I have read and examined ihis application and know the same to be true and correcL All provisions of laws and <br />ordinances c�overning lhis �ype of work will be complied with whether specified herein or nol. The granting of a permit does nol presume <br />to give authority to violale or cancel lhe provision of any other state or local law regulating construction or �he periormance of <br />construction. fhat I am aulhorized by the owner of this property lo peAorm the work for which application is made and I comply with lhe <br />Stale Cont� ctors Law 18.27 RCW and 296.200 WAC. <br />� . , i , /.-��,�� <br />;� ,— <br />��2 <br />