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� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 P_M <br />SITE ADDRESS <br />8 OCUf <br />LEGA LOTNO. BLOCK <br />DESC. <br />OWNER <br />?iF���/,rf�NG ��Tl�,� <br />TENAN7NAME <br />rq�Y _F" <br />�RCEL TAX I.D. # <br />-OoJ - OD 6 � <br />TRACT OR SUBDIVISION Il <br />3� 3/07 �'v�lsyAr�F� <br />CONTACT FOR PERMIT <br />�������� <br />:.,,.,,..,�.�.. <br />�(/E/�'cFrl"�l�v✓'jNG A�Tf�aEiT� <br />CONTR. LICENSE # <br />USE OF BUILDING <br />S�� <br />� <br />� `d7`��� <br />PERMIT # <br />�/1 � / U / - S <br />PHONE <br />f��.T3o 3./�Z / <br />PHONE <br />SiZ.r.sv�. 6 3 90 <br />HEAT SQURCE ONTRACT PRICE OF WORK <br />_ Electric 1 Gas _ Other 9��� �� <br />WORK DESCRIPTION �./a�NC� <br />,����/�/1�'�"loD�l �/.rT/i✓G .L <br />NO. � TYPE OF FIXTURE OR ITEM <br />Tailet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Cbthes washer <br />Water heater <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 FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Ges fireplace <br />Gas rang�. <br />Clothes dryer <br />Renge hood <br />Exhaustfan <br />Heat pump <br />Unk heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceRify lhat I have read and examined this application and know the same to be true and corred. All provisions of laws end <br />ordinances governing this type of work will be complied wilh whether specified herein or not. The granting of a pertnit does not presume <br />to give authority to vidate or cancel the provision of any other state or local law regulating construction or the �erfortnance of <br />construction. That I am authorized by the owner of this property to perform the work for which applicadon is made and I comply with the <br />State �nb�prs Law 18.27 RCW and 296200 WAC. <br />