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SITE ADDRESS <br />cn 3 <' /.%�" � <br />LEGAL� LOT NO. <br />DESC. <br />/'�Cti�C� .' �,✓;�� <br />PERM{T APPLICATI�N <br />ClTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8870 - FAX 425-257-8857 - evww.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ri,,t" c` <br />� <br />BLOCK <br />PARCEL TAX I.D. # <br />;._ . . <br />TRACT OR SUBDIVISIQN tt <br />IZ—�-�`{� <br />:RMIT # <br />,r �, � 7 _ c�2`6 <br />TENANT�lAME I CONTACTFORPERMIT FHONE <br />E-MAIL <br />CONTRACTOR ADORESS CINIZIP PHONE <br />CONTR. LICENSE # j \_ � S' <br />USE OF BUILDING <br />HEATSOURCE <br />Eleclric __ Gas _ Olher <br />ORK DESCRIPTION � <br />� r, <br />��,;: _<�_. �,t„ � � �l� s <�����<�_ v.,,�- <br />,�-: r � <br />PLUMBING <br />NO. I TYpE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Waler healer <br />.� Sink (service/badmop/elc.) <br />Back(low preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />.r:�;� . 5/ L•; <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas pipinc� <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Ranc�e hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Olher <br />l ry.'il'. r/.:: ✓. . .. � C ��, !%' _Ii'< <br />— ��Li, <br />CITY OF EVERCTT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerili(y that I have read and ezamined this application and know the same to be Irue and correcL All provisions of laws and <br />ordinaces goveminc� this type of work will be complied with wl;ether specified herein or not. The grenting of a permit does not presume <br />to 3ive authonty to violate or cancel the p�ovision of any other slale or local law regulating consWction or ihe pedormance of <br />construcGun. ThaJ�l:am auihorized by lhe owner of this property lo periorm the work for which applicatiun is made and I comply with the <br />State Conlraclors Law 18:27 RdW aud 296.200 WAC. <br />� ,^.,-- ,�: ; i� —�5 -��� <br />.,�;,;,W�.� . <br />�o:� <br />--- _ _ _ - - - - - - - y' -- <br />�- <br />�v� <br />�._, . <br />