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SITE A�DRESS <br />6 � <br />LEGAL LOT N0. <br />DESC. <br />OWNER <br />T�L`N�� <br />P�RMIT APPLICe4�IC.N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.eve� ettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />CONTRACTOR �� �� n (. <br />�� <br />CONTR. LICENSE # �� ��V�� � f <br />7 l� <br />BUILDING <br />1 r � <br />PARCEL TAX I.D. # <br />���-� -3- o�l�a- cx <br />28 oS t�3o�J <br />c�+� <br />HEAT SOURCE <br />_ Electdc _ Gas _ Other <br />� K D�� ;PTIO�tJ�j ' i��\a � � IIT �W �"� j � t� <br />ri� <br />�V � �� � � <br />NO. I TYPE OF FIXTURE OR ITEM <br />Tollel <br />Balhlub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sfnk & disposal <br />Dlshwasher <br />Ciolhes washer <br />Waler healer <br />Sink (servicelbar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />q_a� _vk, ; <br />P RMIT�F <br />So�aQ-c <br />J PHONE <br />����� � <br />/ZI PH <br />/� 7 �.-`7 : <br />1 <br />� U%���.� <br />CONTRACT PRICE OF WORK <br />1 'l mr� . �Z'% <br />NO. I TYPE OF PIXTURE OR ITEM � <br />AIC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refdgeration <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerili(y lhal I have read and examined this applicaUon and know lhe same lo be lrue and cerrect. All provisions of laws a�d <br />ordinaces governing lhis lype of work will be compliod wilh whelher specified herein or not. The granling of a permil does not presume <br />to give aulhority to violale oi cancel lhe provision of any other slate or local law regulating wnstruclion or the performance of <br />conslruc . That I a aulhori ed by lhe owner of this properly to perform the work for whfch application is made and I comply wi h the � <br />State G tractors L�w�j8.27 R�W and 296.200 WAC.d � � � ; <br />