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SITE A D SS <br />3�i /� <br />LEGA LOT N0. <br />DESC. <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 8 AM TO 4 PM <br />PARCELTAXI.D.# P�O��� ,O� � <br />�� �- <br />BIOCK TRACT OR SUBDIVISION N <br />�as �03 s �� <br />ennocss � CITY2IP PNONE <br />..`J2 <t�G� ��'J /� <br />TENANTNAME I <br />CONTR. LICENSE K j � <br />/ GU_•� 'S <br />USE OF BUILDING <br />WORK DESCRIPTION <br />._� �j m -2, <br />CONTACj FOR PERMIT(� <br />� <br />�.D-��T IJ�(/�/l:-] <br />�-z� -' ° <br />HEAT SOURCE <br />_ Electric _ Gas _ Other <br />PHONE <br />j1% <br />3� g��/ <br />CONTRACT PRICE OF W ORK <br />/ <br />� �^ �� ,tir � �-v��// b--•-- �/� aZ� J,.� <br />� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Waler healer <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trep <br />Roof drains <br />Other <br />NO. I n'PE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaust tan <br />Heal pump <br />Unil healer <br />Boiler <br />Reirigeralion <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS ]105 <br />I hereby ceritify that I have read and examined this application and know Ihe same to be lrue and corcecl. All provisions of laws and <br />ordinaces governing this type of work will be complied wilh whether speci(ied herein or nol. The granting of a pertnil does nol presume <br />to give authority to viola�e or cancei the provision of any olher stale or local law regulaling construction or ihe pertormance of <br />conslruction. That I am aulhorized by the owner of this property lo peAorm lhe work (or which applicalion is made and I comply with lhe <br />c���� r.,..�.���,,.< i a.,, �a 97 RCW and 296.200 WAC. <br />