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G�( 9' <br />PERM6T APPI.ICATiUN <br />CITY OF EVERETT PERMIT SERVICES <br />32G0 CEDAR STREFT, EVERETT, WA 98201 <br />425-257-f?810 - FAX 425-257-8857 - www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FRUM 8 AM TO 4 PM <br />SITE ADDRESS PARCEL TAX l.D. # <br />3�22 uo'rr �� C�U�c� ��-`��'o z2� <br />LEGAL LOT NO. B OCK TRACT OR SUBDIVISION p <br />DESC. <br />�-ll -�8 <br />2 p,� p'rf--Da� <br />�J <br />PERMIT # <br />��i.L'�'�'(tiE-6.1C� -+PO��X �Zl �#�.1G1�� U..�'c �i��b �a�✓�i-S ��v <br />�7EkANT'NAfiTE— CONiACT FOR PERMIT PHONE <br />�'1.. k�'�1�� -�z5 ��o �-4� <br />-LMAIL <br />CONTRACTOR�Ay�,� J`_ �� AD�RESS CITYI2IP Ph1UNE <br />�`?1c-1 Q. � 1� /U �f � L�V6� �, � -l�� i.a�J�i <br />CONTR.LICENSE# — �A�d�'v����k (�lGry�.� — <br />vT�f`(A- K.Y� - lill �� <br />USE OF BUILDWG I HEAT SOURCE � CONTRACT PRICE OF WO(IK <br />�'%�. �"•� . <br />_ Eleclric _ Gas _ Gthcr <br />WORK DESCRIPTION <br />�-� <br />�1'C�' $�i"�� E=�G�1'�G�c�� �l.� �'fAIN'G�i%�� `,K� <br />oi 1111IIRIAII_ nn <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />La� atory (wash basin) <br />Showcr <br />Kitchen sink R disposal <br />Dishwasher <br />Clolhes washer <br />�Nater heater <br />Sink (service/barlmop/elr,.) <br />Bar.k(low preventer <br />Urinal <br />Drinking Founlain <br />Flo•�x drain <br />Gre ase trap <br />Roo( drains <br />_ OUier <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C – air handling units <br />Forced air syslems <br />Gas piping <br />Water heater <br />G2s fireplace <br />Gas range <br />Clothes dryer <br />R2nge hood <br />Exhaustfan <br />Heatpump <br />Unit heater <br />doiler <br />Refrigerelion <br />YJoodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I hereby ceritify that I have read and examined this applicalion and know Q�e same to be true and r,orrecl. All provisions of laws and <br />ordirace .governing lhis rype of work will be complied wilh whelher specified herei� or noL The granting of a permit does nol presume <br />to give a t�orify 1 violale or cancel the provision o( any olher state or local law regulating construction or lhe performance of <br />consiructiap � Th� I�•,;�y1� aulhorized by Ihe owner of ihis property lo perlorm the work for which applicalion is made and I comply �vilh tnc <br />State Conlr�clolZi�Gv 18.27 RCW and 29G.2001NAC. ./ <br />� �� � � I <br />V -. _—___.---- �------�----�- ---� <br />– - �-- - � ----- ---- � ---- <br />