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<br /> P�RIVIIT APPLICATII.N � `��
<br /> G17Y O�F EVERETT PERMIT SERVIGES ��-s "fl5 �,;;;:
<br /> 3200 CEDAR STREET, EVERETT, WA 98201 �`':
<br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org %:=„::
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<br /> APPLIGAT:ONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED '%�
<br /> SITE ADDRESS � PARCEL TAX I.D.# ERMIT:.
<br /> '�.��,, %�� t� ��'al%. �,?��f1 � ��1t��000 � `-��%; �[�
<br /> LEGAL LOTNO. BLOCK TRACT �
<br /> DESC.
<br /> � OWNER ADDRESS CITY2IP PHONE Y-
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<br />�� �I TENANT NM7E S" ��� �G� ,`C� u� CONTACT FOR PERMIT � PHONE
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<br />:;;.c,> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK ''�.
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<br /> � Eleclric Gas Other
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<br />{��'�;_� WORK DESCRIPTION
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<br />�����.' ' PLUMBING MECHAPJICAL
<br /> ' NO. TYPE OF FIXTURE OR I7EM N0. TYPE OF PIXTURE OR ITEM
<br /> �,'���� Toilet A/C–airhandlingunils
<br />`:" ` _ BathWb Forcedairsystems
<br /> Lavztory(wash basin) Gas piping
<br /> � � Sho�r�er Wzler heater
<br />�,s,�:",���. _ Kitchen sink&disposal _ Gas fireplace �,',,,�,
<br />:� �, � � _ Dishwasher _ Gas ranae
<br /> : � _ Clolhes washer Clothes dryer � '
<br /> _ Laundry tray _ Range hood ¢�
<br /> `r�� I = Sink(service/bar/mop/etc.) = Exhaust fan f�
<br />.-, Backtlow preventer Heat pump G��y
<br />. Urinal Unit healer
<br />' `"' � Drinking Founlain Boiler
<br />�'�; I _ Floordrain _ Refrigeration
<br />�� _ Grease trap _ Woodstooe
<br /> Roof drains Other
<br />?�-�'�i — Other = -
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<br /> '��� ' '� CIN OF EVERETT LOCAL SALES TAX CODE IS 3105
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<br />�:`F:.,. II I hereby.ceriti(y ttat I have,read and examined this application and know the same to be Uue and corre�t. All provisions of laws and � �
<br /> _° �i ordinaces governing this type of work will be complied with whether specified herein or noL The gr niing of a permit does not presume ��*�
<br />;�,4"' I to give aulhbrity to violat cr cancel t e p vision of any other state or local law regulating constructon or the performance of
<br /> a��' i construclion.That f am �i thorized by th�y�ner of thi�property to perform lhe work for v�hich app�ication is made and I comply�viti�the ''��
<br /> State CoNr ctors Law �8.27 R�1/N s 6.200 WAC. _
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