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SITE ADDRESS <br />7 72 1�A <br />L[GA LOTNO. <br />D[SC <br />�u:1Sl <br />TENANT NAME <br />' C <br />,� i� Cr'� c 7� U <br />CONTR. LICENSE x <br />P�,r�ll/IIT APPLICA7't� ,J <br />CITY OF EVERETT PERMIT :;ERVICES <br />3200 CEDAR STREET, EVERETT, W.q 982p1 <br />425-257-8810 — FAX 425-257-8857 — v,n•✓w.everettwa org <br />APPLICATIONS ARE ACCEPTE� FROM 8 AM TO 4 PM <br />� PARCEL TAX I.D. # <br />BLOCK � TRACT OR SUBDIVISION # <br />CONTACT FOR PERMIT <br />�c!' �r.-I�VIf.�(. � <br />USE OF BUiLQii�G <br />C� w. � v—i' e•V� <br />1� � �i \ �''� � <br />WORK DE CRIPTIpN <br />I NO. <br />c C <br />�/ �A-��I c�1�LiS <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bath�ub <br />Lavatory (wash basin) <br />Shower <br />Kltchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heatei <br />Sink (servicelbadmop/e1cJ <br />Backllov: preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />� HEATSOURCE <br />� Llecliic _ Gas _ O�her <br />PHONE <br />PERMIT # <br />�� 9 - �U.iG <br />JTRACT PRICEOO �WORK <br />Y o 6 -� <br />N�� TYPE OF FI%TURE OR ITEM <br />_ A/C — av handling units <br />Forced air systems <br />Gas pipiitg <br />Water healer <br />Gas fiiepiace <br />Gas ran3e <br />Clothes dryer <br />Range hood <br />Ezhaust fac <br />h1ea� pi:mp <br />Unil heater <br />Boiler <br />Refrig�ration <br />Woad�,�,tove <br />Other <br />CITY OF EVERETT LOCAL SALES TAR CODE IS 3105 <br />I hereby ceAify that I have read and examined �his applicalion and know the same Io be Irue and correcl. All provisions of laws and <br />ordinances governing ihis t�pe ol work will be compGed with whether specified herein or nol. The grantinq of a permil does not presume I <br />to give authonty lo violate or cancel ihe provision of any other state or local law mgulaliny constmctior or Ihe perlormance ol '� <br />construc �-Zha1 I am au ized by the owner olihis property to peAorm the work for which application is made and I comply with the I <br />_ Slale C tiacto�t��aw 1 27 R�CW and 29Fi200 WAC. I � � <br />