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SITE ADDRESS <br />LOT N0. <br />PtRMIT APPLlCATIC�N <br />CITY OF EVERETT PERMIT SEFtVICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPT�D FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />S+�ce2. � I O� "3 �i Z c:ooc <br />BLOCK TRACT OR SUBOIVISION R <br />,? —\�i �-i <br />PERMIT # <br />-�rzr t-rc <br />ti'�w.r� Yrc� t! (p �v� cS m S+ce�+ 4Q7�"i V�S• 350• 73�9 <br />TENANT NAME I CONTACT FOR PERMIT PrIONE <br />I E-MAIL <br />CONTRACTOR 1� ADDRESS CITYIZIP PHONE <br />1�ALw�Ey 1-1¢<a-c:.•S •o(Co7. <br />4v25 .J r-izc..a.,w u-�- �r 3��0• S�E <br />CONTR. LICENSE # <br />USE OF 6UILDING <br />WORK DESCRIPTION <br />2«��:� <br />PLU <br />N0. I TYPE OF FIXTI:RE OR ITEM <br />Toilel <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Waler healer <br />Sink (serviceNarlmop/elc.) <br />Sackflow preventer <br />Urinal <br />Drinkin� Founlain <br />Floor drain <br />_ Grsase trap <br />Root drains <br />Olher <br />—� -- <br />5.,� <br />HEATSOURCE <br />_ Electric �Gas _ Olher <br />— �,� <br />J.l'�y.��w.� �JY�rS L'� <br />NO. <br />CONTRACT PRICE OF WORK <br />g � cn <br />34� �. <br />MECHANICAL <br />NPE OF FIXTURE ORlTEM <br />A�C – air handliny units <br />Forced air systems <br />Gas piping <br />Waler healer <br />Gas fireplace <br />Gasrange <br />Clotnes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeralion <br />VVoodstove <br />CIN OF EVERETT LOCAL SALE3 TAX CODE IS 9105 <br />I hereby ceritify thal I have re2d and examined lhis applicalion and know the same t� be true and corrzct. All provisions of laws and <br />ordinaces goveminc� this lype of wcrk will be complied wilh whether specified herein or not The granting ot a psrmit does nol presume <br />to give aulhority lo violale or cancel the provision o( any olher slate or local iaw regulating conslruction �r Ihe pedormance of <br />ca�struction. Thal I am auth�rized by lhe owner of lhis property to perform lhe work for which application i: made and I compfy with the <br />Stale Conlrectors Law 18.27 RCW and 296200 WAC. <br />