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9 <br />PERMIT A�PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO •t PM <br />SITE ADDRESS ` 1 <br />� Z� �1 l V. �Q <br />LEGAL LOTNO. BLOCK <br />DESC. <br />OWNER <br />N�A\P,�AC�\ <br />TENANTNAME <br />CONTR. LICENSEp � 1 5 �7�Q � <br />- J � <br />USE OF BUILDING <br />WORK DESCRIPTION <br />���o�� Se,�\ �.� <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbar/mop/etc.) <br />BackOow preventer <br />Urinal <br />Drinking Fountain <br />Ftoor drain <br />Greaso trap <br />Roof drains <br />Olher <br />IPARCEL TAX I.D. ii <br />TRACT OR SUBDNISION p <br />ADORESS CI <br />CONTACT FOR PERMIT <br />S�ZQ,- 2.1$ ��z v�� <br />�w <br />HEAT SOURCE <br />Electric Gas Olher <br />� <br />PERMIT A� <br />PHONE <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust (an <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I heroby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing Ihis lype of work will be complied with whether spec�ed herein or nol. Tho granting of a permit does not presume <br />lo yive authority to violate or cancel the provision of any other slate or local law regulating conslruction or the pedormance of <br />construction. That I am aulhorized by the owner of this property lo perforrn the work for which application is made and I comply with the <br />S onlrac`or Law 18.27 RCW and 296.200 WAC. �^�p <br />� �,�- - -?_ � �- OZ' „O <br />