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P`tRMIT APPLICATI(�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org � - O1 � <br />G� �/� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITt ADDRESS PARCEL TAX I.D. # RM�/ � >� <br />�i: �� %� l��(.3 ROOIL <br />��O�y3.�0oc�0o�O0_ ✓ -- <br />LOT NO. BLOCK TR T " <br />t�r-, j�t7 �✓iF,z'r� a a•1� ADO , <br />_ wnnovice !`IT <br />-,�.,il � D • (i� a.-C.4y � <br />TENANT,NAME <br />CONTR. UCENSE N'���� yGi �� Q��, <br />USE OF BUILDING <br />CONTACTFOR <br />ADORESS <br />RT L�RT <br />iaoa- oc� �E <br />DNl1N�� <br />��J�€/�,fiT `1'P�-6 3Y:--.rsa, <br />PHONE <br />� • <br />.. a� 'i ' <br />' � lf�G i <br />' C. <br />� CITYRIP PHONE <br />— •... . <br />• ` ... � <br />... { � � <br />, .1 . <br />HEATSOU CE <br />_ Electric _ Gas _ Other <br />WORK DESCRIPTION <br />o� S%v2 � L(���U�J •Si 2cJG�2(� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet �'' <br />BalhWb <br />Lavalory (wash basin) ;/// <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinkinc� Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. <br />PRICE OF WORK <br />v��.0o0 <br />T'PE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping ��.c�i <br />W ater heater <br />Gas fireplace <br />Ga� rangs <br />Clolhes dryer <br />Rangehood <br />Exhaust tan /� <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other�_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS <br />I hereby cerilify lhal I have read and examined this application and know the same to be true �and correct. All provisions oi laws and <br />ordinaces goveminc� this type of �vork will be complied with whether specified herein or not. T�ie granting of a permit does not presume <br />to give lhority to viulale or cancel thep�yyy �sion of any olhor stale or locat law regulating construction or the performance of <br />con ucU n. That I am aut orize Y(e o�ner of lhis property to periorm lhe work for which application is made and I comply wilh the <br />S e Co lra rs La� 8.27 RCW d 2 200 WAC. <br />. /� l (2' <br />�z <br />