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PERMIT APPLICATION <br />CITY OF EVERETT PERM[T SERWICES <br />3200 CEDAR STREET, 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 />SITE ADDRES �� / � �/ PARCEL TAX I.D. N <br />/�j� � /ou��/a e ?s�'OOS 3� 9 On 0.� 1 q O,� <br />LEGAL lOT NnO. BLOCf: TRACT OR SUBDIVISION N <br />DESC. �c S� /�Oc� - �%' D � <br />�'�i��L S 1w �; � <br />/��y �%(� �� � <br />TENANT NAME <br />�'v�v�h��e o1 �-evh��-e.�nv�� <br />L`�NTRA T R <br />CONTR. LICENSE # � 1 T^ �� <br />w< < <br />USE OF BUILDING <br />WORK DESCRIPTION <br />NO. � TYPE OF FIXTURE OR ITEM <br />t� <br />� <br />�_ <br />� <br />Toilet <br />�athtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposa! <br />Dishwashcr <br />Clolhes washer <br />Water heater <br />Sink (serviceNar/mop/elc.) <br />Back(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor draii <br />Grease trap <br />Roof drains <br />Olher <br />/a /--� � <br />� PERMITX <br />11-�' <br />�Z S�2�i 31��Z <br />� e�.�.� �� 9ga o <br />CONTACT FOR PERMIT PHONE <br />��L . e.�a�• 7ZS ��� -)$i� <br />DR S ., „ . / •- • <br />HEAT SOURCE <br />Eleclric � Gas _ Other <br />��S`�L ��S <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />�_ Forced air syslems <br />�_ Gas piping <br />�_ Waler heater <br />,� Gas fireplace <br />Gas range <br />�_ C�othes dryer <br />� Range hood <br />� Exhaust fan <br />_ Heat pump <br />_� Unit heater <br />Boiier <br />Refrigeration <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES TA% CQ'iE IS 3105 <br />I hereby ceritify that I have read and examined this applicalion and know the same to be true and correct. All provisions of laws and <br />ordinaces goveming lhis type of work will be complied wilh whether specitied herein or not. The grantiny o( a permit Aoes not presume <br />lo c�ive authorily lo violale or cancel Qie provision o( any olher state or local law regulating construction or the pertormance of <br />construclion. Thal I am aul�iorized by ihe owner o( perty to peAorm the �vork for which application is made and I comply wilh the <br />Slate ConlracloSs w, .27B,CW and 29 -��C. <br />l/ <br />Z <br />