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SITE ADDRESS <br />NO. <br />PERNfIY APPLIG�,TION <br />C1TY �JF EVERE�'t' I'ERMIT SERVICES <br />;.'200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 - FAX 425-257-8857 - vrww.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FPOM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />-{} Ov3q33ov <br />—� BLOCK TRACT OR 6UBDIVISION # <br /># raoz-ooe-20 <br />ADDRESS <br />1Sh�c�id,� f'd P��� f�-F <br />�CONTACT FOR PERMIT <br />�)enni �C �- �Jon�.s <br />CDUN7Ry Ca�S+ <br />� <br />USE OF BUILDING <br />5 <br />HU V f�[C�aJ <br />I��L Pt� �=��C 13C�f <br />(�03 <br />� <br /># <br />� <br />rnv�. /�/ <br />�3� �s�i"5 <br />(3(c�) �5�1 513� � <br />�...,, �,; �.���,�,sr���,��,���, <br />(�10.rl,pSv� I I e <br />%`d3 `70 <br />5�37 <br />HEAT SOURCE CONTFAGI 1'ttii.c �r �rvn� <br />_ Eleciric � Gas _ Other � (J � �� <br />WORK DESCRIPTION <br />bvild ►�w 5i��1:� -('� mi� m�+dP��c-� ��s�� - 33� <br />� � � �S� <br />NO. I NPE OF FIXTURE OR ITEM <br />� Toilet <br />a Bathlub <br />� Lavatory (Wash basin) <br />Shower <br />i Kitchen sink & disposal <br />� Dishwasher <br />/ Clolhes washer <br />i Water heater <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />N I� � <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />� Forced air systems <br />�'._ Gaspiping <br />� Water heater <br />� Gas fi�eplace <br />Ga� range <br />% Clothes dryer <br />% Range haod <br />„3_ Ezhaust fan <br />Heal pump <br />Unit heater <br />Boiler <br />Retrigeration <br />Woodstave <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriti(y that I have read and examined Ihis application and know the same to be true and correcL All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or noL The granting of a permit does noi presume <br />to give authority to violate or cancel the provision of any other state or local law regula�ing constmction or the pertormance of <br />cortstruction. That I am authorized by Ihe owner of ihis property to perform the work for which application is made and I comply with the <br />su,e Contractors Law 1827 RCW and 296 �00 WAC. � � <br />�/L <br />