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�. <br />PERMIT APPLICATIUN <br />CITY OF EVERETT PERIViIT 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 Phl <br />SITE ADDRESS �! <br />� <br />LEGAL LOT N0. <br />DESC. <br />OWNER <br />�� an kelSon �aC <br />TEN.4NT NAME <br />/. / // L_ N �_' I _ <br />CONTR. LICENSE # � �� <br />l- I <br />USE OF BUILDING <br />�e?�'ai�— /lo e�ian9e. <br />�� <br />�ml J! ��PrARCEL TAX I.D. # <br />F� <br />TRACTOR SUBDIVISION # <br />p.�o.�go� 982�0 <br />,.. I „L.�,.._..., r.�n98 <br />y -- �f -o� <br />?MI`f # <br />�; 03 r� <br />0 <br />fACT FOR PERMIT �',�// ` PHONE <br />S�` �1C'r`�I"��iL� ,^l'/i _(� <br />Il �WnP✓ �C+1[{� �� E-MA)L � 7 U�' d:�:�r� <br />2ESS CITYIZIP PHONE <br />HEAT SOURCE �CONTRAC7 PRICE OF WORK <br />Ez�s%� no c�o-n - � . � <br />Eleclric � Gas _ her ,� ' �� � <br />WORK DESCRIPTION fi, f, ��f�„ �t, //Pl �Uri� P��/X/ � <br />/ l�emo !'e✓P/� �n�'ii.miwal�r�--n�afi� �c v� <br />Add ane �rtro�+� -��+�u�ft �^` I �/2�AND �rit� F13�2o�oB �U�'O�o. floar Plar� <br />°�• e��ann rasfram•�—daa. ple,+a_ 9"� <br />.�. /�� o2X ff�/oor',�o�f}'J O�Q/ SMaI� Sf4irWei�— See.. �%pjio� Fleor �law <br />NO. I `� TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposa� <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasetrep <br />Roof drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/� — air handling units <br />Forced air systems <br />Gas piping <br />VVater heater �/ <br />Gas fireplace N bI1 Q/ <br />Gas renge <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />CIIY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby r,erilify thal I have read and examinud lhis applicalion and know lhe same to be true and correcl All provisions of laws and <br />ordinaces governing this lype of work will be complied wilh whelher specifed herein or noL The granting o( a permil does not presume <br />to give a ity to violale or cancel the provi>ion of any olher slale or local law regulating construr,tion or the performance of <br />con ction, at 1 am au}�orized by the owner of this property to perform lhe work for which applicalion is made and I comply with the <br />S le Conkact rs Latiw1B Z7 RCVg and 29F,.200 WAC. , / <br />0 S �/ <br />Z <br />