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SITE ADDRESS <br />/�� 1� <br />�f'c�� �rctino�o <br />7ENANTNAME <br />RMIT 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 <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />PARCEL TAX I.D. t <br />BLOCN I TRACT OR SUBDMSION 11 <br />CONTACT FOR PERMR <br />��C-r/R/rf�� <br />R�fr s�t �1� � .%rv� <br />ZI<Z <br />USE OF BUILDING <br />/Q P,� <br />WORK DESCRIPTION <br />NO. � TYPE OF'IXTURE OR ITEM <br />Toilel <br />Balhtub <br />Lavatory (wash �asin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moplelc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />/ -/ b <br />zos-�99-� �37 <br />PHONE <br />y2> - 2 38'—/7P 6 <br />3�0/ ,c�iw�'I`r�.,.9T���zs'-Z� 1`-Z/C/ <br />�� <br />HEAT SOURCE <br />_ Electric %� Gas _ Olher <br />�-tirH a �-�- <br />CONTRACT PRICE oF woRR <br />/8'6O ?` <br />NO. I TYPE OF FI%TURE OR ITEM <br />AIC — alr handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALE5 TAl( COOE IS 3705 <br />I hereby ceritify that I have read and examined this application and krww the same lo be We and correct. All provisbns of Iaws and <br />ordinaces goveming this lype of work will be complied wilh whether specifiad herein or not. The granting of a pertnit does not presume <br />to give authoriry to violate or cancel the provision of any other state or local law regulating constnrcdon or the performance of <br />construction. Thal I am authorized by the owner of this property to perfortn the woric for which application is made and I comply with the <br />Stat7Conlraytor�Law 18.27 R�W and 29G200 WAC. /^Q_O � <br />�> l /� %� (/ <br />