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SITE ADDRESS <br />,� <br />LEGAL ' LOT NO. <br />DESC. <br />OW�IER <br />��1��1�� <br />TENAtlT NAME <br />CONTRA� <br />PtRMIT APPLICATi(�N <br />CITY OF EVERETT PERNlIT S�RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 – FAX 425-257-8857 – www.everettwa.org <br />APPLICATIONS ARE ACCFPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.O. # <br />/D -1�-0..6 <br />fiMIT # <br />%/0 - 9 <br />-�/�,D��� yz���-//� <br />IR PERMI pHC1NE <br />/� DRESS �n��C CINIZIP PHONE <br />/:Y�L.�—�y � �,(� 'J �/ t�`Zof si 5 s� r' (� <br />CONTR. LICEP:SE i� / <br />/�i��E 5���/,� ��3� �� y' ��3 r <br />USE OF BUILDING / /, > I1EAT SOURCE CONTRf CT PRICE OF WORK <br />`� � � _v� I — — — <br />Eleclric Gas Ulher <br />`NORK DF:SGRIPTION <br />NO. I 1YPE OF FIXTURE OR ITEM <br />Toilet <br />Balhlub <br />Lavalory (wash basin) <br />Shower <br />� . Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />� - Walen c�aler <br />Sink (service/�ar/mop/elc.) <br />Backflow prevenler <br />Urinal <br />_ Drinking Founlai� <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I TYPF.OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit healer <br />Boiler <br />Refrigeration <br />W oodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TNC CODE IS 3105 <br />I hereby ceriti(y that I have read and examined lhis application anA F;now Ihe same to be lrue and cnrrecL All provicions ct laws and <br />ordinaces governing this type of work will be complied wilh whether speci(i�d herein or noL The granling of a permit does not presume <br />to give aulhonty to violate or cancel Ihe provision ot any other stale or 1oc21 law regulatin� construction or the per(ormance ot <br />consiruclion. That I am authorized by the owner o( this property lo per(orm the work fur which application is made and I comply with the <br />State CeNractors Law tf3.27 RCb'V and 29�200 WAC. <br />�i � � ,�-�� ��' i r/_� �7� <br />;�'� l' �� ���=��- <br />....�........,,....._–�..— ...................:_.. �---• ^_,_ <br />