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SITE ADDRESS <br />2��i H�Yr <br />LEGA LOT NO. <br />DESC. <br />P�RlVIIT APPLICATI�W <br />rITY OF EVERETT PERMIT SERVIC�cS <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />415-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />C� i r�; �� F� ��ti2�'� <br />reHarrrr+n►�e oF�-,�.lul-�Uhtl <br />'\1=-� C��%iVCll. <br />CONTR. LICENSE M <br />LPARCEL TAX 1.0. # PERMR N <br />o�}-3t�� �;�Zoocc�► ���,G�-� <br />TRA( T OR SUBDINSION / <br />CONTACT FOR PERM17 <br />o i . {'��r� <br />���r1-�� v�{� �l �,l <br />USE OF BUILDING HEAT SOURCE <br />G'.f`av��� - �i-� � niF s�l�r� - <br />Electric .� Gas _ Other <br />L7l.hti�i 1'X-l�i��I_ :. G� — <br />WORK DESCRIPTION <br />�1"�'�;N4��r t �-�t1'�'t�l� ri��v'� <br />TYPE OF FIXTURE OH ITEIA <br />Toilel <br />Balhlub <br />Lavatory (wash basin) <br />3hower <br />Kitchen sink & disposal <br />Dishwasher <br />� Clothes wasner <br />�_ wator heater <br />Sink (service/badmop/etc.) <br />Backllow preventer <br />Urinal <br />I Orinking Founlain <br />j Floor drain <br />_ � Grease trap <br />� Roo( drains <br />O�her _ <br />u.�r.�rMo�EL��� 3zZ-3��z <br />ciI'(' ct� C 6ii�fi�`Ci"��.c0� � i <br />CONTRACT PRtCE OF WORK <br />� -�a—,�� -� �-�- <br />� �-r;.� y��) i- <br />1'-t�'�- ��b1-T'� C i;V (�11� , � , , <br />i. <br />Np. I 7YGE OF FI7CTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas lireplace <br />Gasrange <br />Cbthes dryer <br />Range hood <br />Exhaust lan <br />Heat pump <br />Unit heater <br />Boiter <br />Refrigeration <br />Woodstovo <br />Olher <br />CITY OF EVERETT LOCAL SALES TA7( COD81$ 7105 <br />I hereby ceritily Ihal I hava read and �xamined this applicalion and know ihe same to be Irue and correc�. All provisions ol laws and <br />ordinaces goveming this type ul work will be complied with whelher specified he�ein or not. ThQ granting of a pormi! doss not presume <br />to �ive authority to violate or cancel �he provision ol any other stato or local law regulating construction or the pedorm�+nce ol <br />cons�ruction. That I am authorized by Ihe owner ol �his property to perform ihe work lor which application is mado ard I comply wilh tt�e <br />State Contractors Law 18R7 RCW�and 296.200 WAC. <br />� � . . . , l�- ! - � r l' �-,-� ' � ��� l,, ri <br />mcuu ndem � ..a,o I <br />�__ J /� <br />