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pERMIT APPLICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />SITE ADDRESS <br />S J S' /�-� �4��iS��� S i <br />LEGA LOTNO. BLOCK <br />,CA C��c. L'J u�✓��-y C'.c>�Si <br />TENANTNAME <br />p� in G+ . iti+i. <br />CONTF. IJCENSE p <br />PARCEL TAX I.D. 7f <br />TRACT OR SUBDIVISION p <br />AUDRESS <br />��� �vx i3vy <br />ICONTACT FOR PEflMR <br />1ti33u i1�1nr <br />/f. ✓c ..s,C <br />Z7Lc. L <br />USE OF BUILDING <br />Si=/L <br />HEATSOURCE <br />/v�AF7v5Via�c <br />PHONE <br />E-MAIL <br />�� <br />A/'u�.•v�U..i <br />`�J'Za3 <br />Electric _ Gas _ ��her <br /># <br />�6C � ys�'r' -S"�3, <br />jE�v Ye3 �KGZ <br />C6NTRACT PRICE OF WORK <br />r� �V ;�(.) <br />WORK DESCRIPTION <br />iNST�LC �/�2-t �SP��NKcc�'S� /,�' .tJt-Zl.,� Srf2.. <br />NO. I TYPE OF FlX7URE OR ITEM <br />ione� <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backllow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Rool drains <br />Other <br />ryp, I TVPE OF FI%TURE OR ITFlA <br />A/C-airhandlinc units <br />Forced air systems <br />Gas pipirg <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Flange hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Relriqeration <br />Woodstove <br />Olher <br />�_ S �-�N/�L�:�. N'C�-i%S <br />CRY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the sarne to be true and conect. All provisions of laws and <br />ordinaces goveming this type of work will be complied with wheiher specified herein or not. The granting of a permit does not presuma <br />to yive authoriry to violate or cancel the provision ol any other stato or Iceal law regulaling construction or the pertormance ot <br />construction. That I am authorized by the owner ol Ihis property to perform the work lor which application is made and I comply with the <br />State Contracbrs Law 18,27 RCW and 296200 WAC. <br />