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f <br />PEr�Ml�T APPLICATION <br />�ITY OF t'v'GFi�TT PERMIT SERVICES <br />3200 CEDAF' STkEET, EVERE'I-f, WA 9820i <br />425-257-8810 — F�4X 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROA18 AM TO Q PM <br />SITE ADDRE55 <br />�" C-� zo���.���o <br />LEGA LOTNO. ELOC� <br />I DESC. <br />UWNER <br />� <br />rrhR..��Q�•- Feikr ;���S��.c�w� <br />7L-NANTN ME ' <br />.i.� �tykr� �/QA r r'Pew�ui5<'rn <br />CM NFCt YlC' I N G <br />li CONRi. UCENSE <br />�i�( i-1t���� �5R4 <br />II USE OF BUILDING <br />WORK OESCRIPTION <br />Ins�zill ��5 <br />NO. I NPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Showcr <br />Kitchan sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e�c.) <br />Backflow preventcr <br />Urinal <br />Drinking Fountaln <br />Floor drain <br />Greasa �rap <br />Root drains <br />Other <br />PARCEL TAX I.D. # <br />TflACT GR SUBDIVISION # <br />U( )`i' 1 . <br />FOR PC-RMIT <br />����� <br />��ds �rC�CtC�tuCu� <br />i <br />HEATSOURCF <br />_ Electric �Gas _ O�her <br />(,�'rlr <br />�`�u' a5 <br />PERMIT # <br />M� -c��� <br />PHONE.. <br />36o-E�r, l g�� <br />C�erc=� G.S'� 1 <br />Zf-2 S Z S`i l� <br />CUNTRACT PRICE OF <br />��LJ.�� <br />rnac� � qc�s �oqS <br />J �1 <br />NO. I TYPE OF FIXTURE OR fTEM <br />AiC — air handling vnits <br />1 � Forced air syslems <br />� Gas piping <br />Water heater <br />4� Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />_ Healpump <br />Uni� heater <br />Boilcr <br />_ Relrigeration <br />Woodstove <br />CI7Y OF EVERETT LOCAL SALES TAX COfJE IS 3105 <br />1 hereby ceritify �hat I have read and examined this application and know lhe same to be irue and wrrect. All provisions af laws and <br />ordinaces goveming this rype of work will be complied with whether specifed here�n or not. The granting of a pertnit does not presume <br />to give au�horiry (o viola�e or cancel the provision of any other state or local law regulating construction or �he perlormance of <br />wnstructian. T�iat I am authorized by the uwner of this property to perfarm the work tor which application is made and I comp!y with the <br />State ContracfoFs Law 18.27 FiGN,and 28 .G 2(j0 WAC. i i <br />� I /` � <br />ate <br />