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SITE ADDRESS <br />�� <br />LEGA LOT NO. <br />DESC. <br />OWNER <br />�%�,��!/!�6 <br />TENANTNAME <br />sA�r� <br />� <br />.'� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICE:� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />o CU.T T <br />BLOCK <br />li��,FFTi f�:�J/�G AvT/��'r <br />CONTR. LICENSE # <br />USE OF BUILDING <br />5�.� <br />TAX I.D. # <br />!- nv-� - o a,� <br />TRACT OR SUBDIVISION # <br />� C6rB�qv� <br />CONTACT FOR PERMIT <br />�� <br />5 -I �?� �� <br />FERMIT # <br />y�.s��3. <br />PHONE <br />/?..r.f"'n�. 6s 96 <br />HEATS CE CONTRAGTPRIGEUhWVKK <br />Electric Gas _ Otiier ��L, �� � <br />WORK DESCRIPTION <br />�F�qi����aG�l E",Y/.fTi��� .��s���-.��E— <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />ClTY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />i hereby certity that I have read and examined this application and know lhe 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 pertnit does not presume <br />to give authority to violate or cancel the provision of any olher stale or Iocai law regulating construdion or the perfortnance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I wmply wilh the <br />State C�yi(a�jors Law 18.27 RCW and 2�6.200 WAC. <br />