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SITE ADDRESS <br />�Y03 Lew��� <br />LEGA l0T NO. <br />DESC. �1 <br />TENANT <br />coninncivn C �1 <br />J <br />CONTR. UCENSE N <br />USE OF BUILDING <br />��RMIT APPLICATIt�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAl( I.D. A <br />�li �4 �'�3 <br />9LOCK I �La��e`SIO��e\c:y� <br />i <br />jJ <br />ADORESS <br />5RD3 Lowe��12� <br />ICONTACT POh PERMIT <br />KA t"G�/ J ll->C \� <br />I — HEATSOURCE <br />Electric _ Gas ,� Olher <br />�j,2i-aZq u - 5 `i � � <br />PHONE a0�'�55-'-11.�� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION l <br />/��- � 7' � 'i� �lvta�,? W o—l�'�° <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (serviceNar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Fli�or drain <br />Gr.�ase lrap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C – air handling units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas tir�place <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhauslian <br />Heal pump <br />Unit heater <br />Boiler <br />Refrioeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TA7( CODE IS 3705 <br />I hereby cerilify that I have read and examined this applicalion and know the same lo be true aM cortect. All provisions of laws and <br />ordinaces governing this lype of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to c�ive aulhoriry lo violate or cancel Ihe provision of any other slate or Ioc2i law regulaling construction or the performance of <br />conslruclion. That I am authorized by the owner o( lhis property lo perform lhe work for which applicalion is made and I comply wilh the <br />Stale&9���rac}ars Law 1827 RCW and 296.7nn WAC. <br />�• I � <br />