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SITE ADDRESS <br />LEGAL , LQT O. � <br />DESC. <br />PtRMIT APPLICATIC�N <br />GITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881 U— FAX 425-257-E857 — www.everettwa.org <br />:iPPLICl.TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� PARCEL TAX I.D. # <br />,�� P.� � ��� �u� oo �}o � <br />6LOCK� TRACT <br />C �I2. i'���-rH U�aha,�i lr1 �u La�irt��� �i <br />TENP.NT NAME <br />� <br />h� / - <br />CONTRACTOR <br />CONTR. LICENSE # <br />USE OF BUILDING <br />`�TZ�CA��� <br />WORK DESCRIPTION <br />��I �a.�-=�r Y� <br />Np, I TYPE. 0� FIXTURE OR ITEM <br />Toilel <br />Balhtub <br />Lav2lory (wash basin) <br />Shower <br />Kitchen sink & Cisposal <br />Dishwasher <br />Clolhes washer <br />Waler healer <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Olher <br />CONTACT FOR PERMIT <br />E �A,Nr W � �so N <br />A�DRESS <br />NEATSOURCE <br />�6 _g�-G6 <br />PERMIT # <br />I ix�Gb9-a�l .� <br />�� <br />PHONE , <br />1J�Q.Ett �{�-'•3'3 a <br />PHONE <br />�d5-3S5 �-.IS <br />f,ITYIZIP PHONE <br />_ Eleclric _ Gas _ Olher (�l ON t <br />.:� J�� <�CI,I c� <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas (ireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhauslfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodslove <br />CIN OF EVERETT LOCFL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correcL All provisions of laws and <br />ordinaces goveming this �ype o( work will be complied wilh whether specified herein or noL The granting of a permit does nol presume <br />to give aulhority to violat� or cancel the provision of any other state or local law regulating consWclion or lhe pedormance of <br />construction. That I am aulhorized by the owner of this property to pederm ihe work for which application is made and I comply with the <br />Stale Coniraclors Law 1827 RCW and 296.200 WAC. <br />'��. � ,.,; ,� � )i Gt�,c<¢.�� �'- 9 ' �' L� <br />