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SITE ADDRESS <br />NO. <br />TENANTNAME <br />��;r�S <br />R <br />PERMI� APPLiCATION <br />CITY OF EVERETT PERM�T SERV(CES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM T04 F`M <br />PARCEL TAX I.D. !t <br />��•7�:- r 7/_ �� : <br />BLOCK <br />/ C, � �J (� �'�A�EAE'S� <br />,E� iu�. pC'i, .� i/,;i <br />corrra. ucer+sr- � � lC� <br />USE OF BUI'.DING <br />GC';L.� yl..'� <br />FOR <br />pEjiM�T # % . <br />,-, 7� � � C''� " <br />PHONE �I �S .5 �c.� J % S-� / <br />r,4.,�ys��,'/i�,r.�r,= 9�z;�; <br />l< <i �•� <br />HEATSOURCE <br />- ;�� - �, �', <br />%(� Electric __ Gas _ 01her <br />;F�/ia'�: s�'-� v� q �. � ,, � <br />I � i. <br />'7i=S�4.J 753� <br />PRICE OF WORIC <br />WORKDESCRIPTiUN�H��/�� ��CIr� �,� �K�S'i-iN� !�<<il��iKt`- //�OV� %Nf-pl��,� lt ,I/S <br />/',� r�l,.c1-t c;.s' )rrc'�ts-lTii/' /�— � � r, f ! <br />�`t.ic� �i',��i�:�,�� L/�Sf��l .� � S. I�-�f�ti'l._ LK1S'�lr-/ 114�R'y� <br />>;�-'„�.il �I:ii;,����L. a„�.��' K',p��,cv ctJ��-ll� S'l<<.,��/��'7�lU<-r�<%F,-,.,l.,G' _�1--i��,^i_ <br />NO. I TYPE UF FlI(TURE OR ITEM <br />Toilet <br />Ba�Mub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Wa�er healer <br />Sink (service/badmoWelc.) <br />Backllow preventer <br />Urinal <br />Drinking Foun�air <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ <br />NO. <br />TYf'E OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Wa1en c�ater <br />Gas lireplace <br />Gas range <br />Clolhes drycr <br />Rangc hood <br />[xhaust fan <br />Hca� pump <br />Unit healer <br />9oiler <br />Re(rige2tion <br />Woads!ove <br />CITV OF EVERETT LOCAL SALES TA% CODE IS 7105 <br />I hereby centify iha� I have read and examined lhis application and know the saTe to be true and correct. All provisions of laws and <br />ordinaces governing this rype of work will be complied with whelher specified herein or noL The granting oi a permit does not presume <br />to give authonly to violate cr cancel the provision ol any other state or loral law regulating consWction or ihe pedormance ot <br />conslruc�ion. Tha� I am authorized by the owner ol this propehy to padom Ihe w�rk for w'nich application is made and I comply wilh the <br />Stale Contrac�lors law 18.27 RCW and 29(i.200 WAC. <br />1 <br />/1 <br />