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��. �. !1�',.; ;�i7".�'�. <br />SITE ADpflESS <br />��3 IS <br />LEGAL LOi N0. <br />DESC. <br />PERNiIT APPLIGATION <br />CITY OF EVERETT PEREVIIT SERVICES <br />3200 Ct•DAR STREET, E\'ERETT, WA 98201 <br />425•257-8810 - FAX 425•257-8857 - tiw+w.everettwa.org <br />APPLICATIONS ARE ACCEPTED FflOM 8 Ah1 TO 4 PI.7 <br />PARCEL TqX I.D, # <br />BLOI'K I TRAC70RSU8DIVISIONp <br />yr.ii � � <br />i3lD-U35 <br />��� i �urq-eoi.� �xanno nS �V� �Z�21A7 �7c�� <br />7E�JANT Nqt•1F I CONTAC7 FOR pEF�,tli <br />{ rHor,el�ZS �`�- - �,l-% <br />cn�. '�"`'� � CI PE•7.1AI I��FL� CG11IlEt:�� <br />M�a inq lnc. ��-�� ar�,+��'j,,���-e-ve� e�r Q <br />COIl7R�LICEI�SF -{ �V�� ��J25if���� <br />� M ��,r�i r,, n l� C rn. <br />USE OF BUILdIN�3 <br />�rvnK oESCRIPTION <br />�����q� <br />HEAT SOURCE I CONTRACT PRICE OF VVORK <br />____ Eleclrrc �as Olher ��L' L� � ( <br />—L —7 1 J <br />NO. I TYPE OF FIXTURE Oq ITEM11 <br />I Toilzt <br />Bathtub <br />Lavalory (�vash basin) <br />Showcr <br />Kitchen sink & disposal <br />pishwasher <br />Ciothes washer <br />Waler heater <br />Slnk (servlCo/badmop/elc.) <br />BackOow prevonter <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grcase Irap <br />Roof drains <br />Olher <br />N0. I TYPE OF FIXTUFE OR ITE1�1 <br />-j- <br />A/C — air hantlling unIIS <br />Forced aii systems <br />Gas p�pinp <br />Walcr hoaler <br />Gas Ilreplace <br />Gas range <br />Clothos dryer <br />Rangc hood <br />Eshaust lan <br />lieal pump <br />Unil healdr <br />�oiler <br />Ho6i�erd�ion <br />Woodsmv <br />oina� �S rv� Q,CQ, <br />CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3104 <br />I hereby cetlllfy Ihat ! have read and examined this applicalion and I<now the spme io be Irue and corroct. All provisions ol laws antl <br />ordinace; povemin0 ihl� type ol work wlll be complied wllh �vhe�hor specilietl heroin or noL The graming o( a permit does not presume <br />to flive authority t0 violote or cancel lhe provision of any mhsr slate or local law regulaunp construction or ihe podc�manca o! <br />consvuchon. Thal I am authorizod by iho owner o1 ihis p��peny �o pertorm ihe work for which applicntion is made and I comply wilh Ihe <br />State Gontraclors Law 10.27 qCW and 296.200 WAC. <br />�1 . . � �-� <br />