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SITE ADDRESS <br />LEGAL� LO�T NO. <br />DESC. <br />OWNER <br />Z ��� � <br />� <br />PtRMIT APPLICATIVN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-88. 7— www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -'� �-"� � <br />�f <br />BLOCK <br />PARCEL TA7( I.D. # <br />TR� CT OR SUBDIVISION # <br />TENANTNAME v CONTACI*ORPERMIT PHONE Y�� y�8 ,�og� <br />I KCI� JD�QY1 E•MAIL <br />S �{oaQ �r�efbYlEa � 8 �o <br />CONTR. LICENSE p A L� T N R��j a o 1� E <br />USE OF BUILDING I HEAT SOURCE <br />�('� _ Eleclric _ Gas _ <br />WORK DESCRIPTION '� n L� ��� � OlS"1J <br />lY <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhlub <br />La��atory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (servicelbar/mop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher _ <br />L <br />Olher <br />y�5 y2 � <br />CONTRACT PRICE OF WORK <br />�,750 <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — alr handling unils <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas lireplace <br />Gasrange <br />C�othes dryer <br />Ranc�o hood <br />Exhausl (an <br />Heal pump <br />Unit heater <br />Boiier <br />Retrigeralion <br />Woodslove <br />CITY OF EVFRETT LOCAL SALES TAX CODE IS 7105 <br />I hereby cerili(y Ihal I have read and examined this application and know lhe samo to be true and correcL All provisions of Iaws and <br />ordinaces governing this type o( work will be complied wilh whelher specilied herein or nol The granting of a permit does nol prosume <br />lo give authority lo violale or cancel �he provision of any olher slato or local Iaw rec�u�alin� conslruction or ihe performance of <br />conslruction. Thal I am authorized by Ihe owner ot lhis property to pedorm ihe work for which applicalion is made and I comply wilh Ihe <br />State Conlraclors 18.27 W and 296.200 WAC. <br />Xa�, ti 5,�� � .� � aoo� <br />