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. <br />SITE ADDRESS � <br />Z�LEGH LOTNO. <br />PtRMIT APPLICATION���;�����, ��, <br />CITY OF EVERE7T PERMIT SERVIa S� �` I�)� <br />3200 CEDAR STREET, EVERETT, WA 98201 ��� � %(III�, <br />425-257-8810 — FAX 425-257-8857 — wuvw.evereriwa.org � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4. P <br />PARCEL TAX I.D. R <br />9'b2O3 0 � 90 0�o-a yoz <br />BLOCK TRACTOHSUBDIVISION• <br />ADDRESS CIP(ZI <br />32z K lls,� L� f�.�.df � <br />I COHTACT FOfl EHMR <br />was h p��. w�.,L� ; I-l.rQ,� �s "� i��a �; ���,� J� <br />corme.ucvu�.���iLCX-9Sa o1� /'1—Jz/!P✓u.e, �,�. <br />USE OF BUILDING <br />HEATSOURCE <br />_ Eleclric _ Gas _ Olher <br />WORK OESCRIP'T10N n/ !„ � L // l�� � <br />(}Y�Q.�nOG O u-T � / <br />Np, I TYPE OF FlXTLRE OR ITEIA <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Slmwer <br />Kitchen sir�C 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbar/mopletc.) <br />Backtlow preventer <br />Urinel <br />Drinking Fountain <br />Floor d2in <br />Grease trap <br />Rool drains <br />Other <br />%�g` / <br />y�Cl ll' O� LVciiET7 <br />_ - , � ��,: > :. <br />..-.��� �PEflNfTil - <br />PHONE �D <br />��yy�<<�.��, <br />��- <br />9�g-�S�g <br />CONTRACT PRICE OF WORK <br />�%5 � <br />(/"�"' ���y <br />MECHANICAL <br />yp. I TYPE OF Fll(TURE ON ITEAI <br />.NC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas lireplace <br />Gas range <br />Clothes dryer <br />Rarge hood <br />Exhaust fan <br />Heat pump <br />Unii heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />CITY OF EVEREiT LOCAL SALES TA% CODE IS 3105 <br />I hereby ceritify thal I have read and examined �his application and know the same to be iruo and cortect. AII provisions ot laws and <br />ordinaces governing this lype ol work will be compiied with whether speci(ied herein or not. The granting o1 a permit Aces not presume <br />to give aulhority to violale or cancel Ihe provision ol any olher state or local law regulating construction or the peAormance of <br />consinx.Mion. That I am aulhorized by ihe owner of lhis property to perform Ihe work for which application is made and I comply with the <br />State Cantradors Law 78.27 RCW and 296200 WAC. <br />