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SITE ADDRESS <br />—� _ <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRE�T, 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 />PARCEL TAX I.D. N <br />3�s�� k,�ti S�, L�t,�� `1BZ�1 � <br />LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION S <br />Lz�is�,�i (�.-�t-�,� <br />TENANTNAME <br />3 S!I fi N�/� .5�. �vc.�e ff , yBZ�� <br />I CONTACT FOR PERMIT PHONE <br />CONTRACTOR ^""^""' <br />Pu,;,fs«�, ,£ac, i�z �. d�:r�l, S�, <br />CONTR. LICENSE # �p��I.� �r %�S�/YI �i <br />USE OF BUILDING <br />WORK DESCRIPTION <br />l�i�A��.CC Sc'CJEr L, ,7 t <br />Np, I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitcnen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/bar/mop/etc.) <br />Backtlow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roo( drains , <br />�_ Olher C • ,�`�e <br />HEATSOURCE <br />� <br />yZS-3�3 -k�9� <br />C�tlr�f', y$Zo3 `iZ,S-3Z%•`ID(/ <br />_ Eleclric _ Gas _ Other <br />�/l'l /� /�i14 S C' }G S �/GC / <br />�'�,�,���,e�� �s� e, <br />CONTRACT PRICE OF WORK <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 />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Retrigeralion <br />Woodslove <br />Other <br />CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriti(y thal I have read and examined lhis applicalion and know the same lo be true and correcl. All provisions of laws and <br />ordinaces governing this lype of work will be complied wilh whelher specified herein or not. The granting of a pertnit does not presume <br />to give authority to violate or cancel the provision ot any olher slate or local law regulating construction ar the perfortnance o( <br />construclion. Tha� I am aulhorized by the owner of this property lo perform lhe work (or which applicalion is made and I comply wilh lhe <br />State Contraclora Lay�-�8.27 RCW and 296.200 WAC. � <br />