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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE'T', EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 —www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />ADDRESS PARCEL TAX I.D. # <br />�?i Loc�fT" ��5'9Z-oo/-oo�-oao <br />LOT NO. BLOCK I TRACT OR SUB�IVISION # <br />�Z <br />� <br />quuncaa <br />,�/odsi,�c. A�rfro�.�r/ 3��� c6��y �d�- F-��,�ir �z.r. so3. �rz/ <br />9,P7 0 � <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />.��/N�FF S�zr S�� E3 9 d <br />5��� E�7JIAIL <br />C A C 2P <br />F//�iPE7T Ff/idli/�/G A vTf/o�/7� <br />CONTR. LICENSE # . <br />j USE OF BUILDING <br />I SF�' <br />HEATSOURCE <br />_ Electric ��as _ Olher <br />GONTRAI:I YKil:t Vr wunn <br />WORK DESCRIPTION <br />,���Al,��/��/���E-� �Xi�r�i�✓G .e�s/D�id�'� <br />NO. I TYFE 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 heaier <br />Sink (service/barlmop/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 F�XTURE OR ITEM <br />A/C — air handting units <br />Forced alr systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaust Fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify 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 ihis type of work will be complied with whether specified herein or not. The granting of a permft does not presume <br />to give uthority to violate or cancel the provision of any other slate or local iaw regulating construction or the perfortnance of <br />constru ion. That I am authorized by the owner of this property to perform the work for which application is made and I comply wilh the <br />e���o r adors Law 18.27 RCW and 296.200 WAC. <br />