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SIT'- ADDRESS <br />�70/ G, <br />LEGA LOT NO. <br />TENANT NAME <br />S.�Q��E <br />C <br />PERMIT APPLIC�,TION <br />CITY OF EVERE�'T FERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTI_D F'ROM 8 AM TO 4 PM 5"� 5��� <br />BLOCK <br />Fv�,F'�Ti f/o'�f/�G .9vT/�/'1 <br />COWTR. LICENSE # <br />USE OF BUILDING <br />5�,� <br />pARCEL TAX I.D. # <br />��_�j �t/_ D D U- Cl d,� <br />TRACT OR SUBDIVISION # <br />� C���,��i�� <br />PERMIT # <br />y�s-��3. �r� � <br />CONTACT FOR PERMIT �2�P�HO�n� � J �b <br />�� / ��Fi E-MAIL <br />HEAT S RCE CONTRACT PRICE OF WORK <br />_ Electric Gas _ Other 1���%�� � <br />WORK DESCRIPTION <br />%�i.��-��aG�� �,�ifTir��� .e�si�E-�cE <br />NG <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Ba1hWb <br />l.avatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clclhes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Foun�ain <br />_ Floor drain <br />_ Grease �rap <br />__ Roofdreins <br />i C�Iher <br />N0. I 1YPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />E'�haust fan <br />!�eal pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Other_ <br />CITY OF EVERETT LOCAL SALES TAX OODE IS 9105 <br />I hereby cerfify that I have read and examined this soplication and know the same to be true and correct. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or not. The granting of a perm�! does nol presume <br />to give authonty lo violale or cancel ihe prot�ision of any other s�ate or local law regulaling wnslruction or the perfurmance o( <br />conslruction. That I am authori�ed by the owner of this property to perfurm the work for which applica!ion is m2de and I wmply wilh lhe <br />Slate C�![a�ors Law 1827 RCW and 296200 WAC. <br />