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PERMIT APPLICATIUN <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 8 AM TO 4 PM <br />SITE ADDRESS <br />-70� t� ��vece� <br />LEGAL LOTNO. BLOCK <br />DESC. 7 <br />OWNER <br />�c.���;� i��vle5 .Px��t-I'x� <br />TENANTNAME <br />� �� <br />NTRA �,� ,r.y \ I� � � �On• <br />CONTR. LICENSE p <br />WA Li�.EC� <br />USE OF BUILDING <br />5 � �c� �e-Fum�l�-t <br />PARCEL TAX I.D. p <br />TRACT OR SUBDIVISION p <br />CONTACT FOR PERMIT <br />Z21 S�-� r1v� <br />Su �je- e� <br />HEATSOURCE <br />� Electric _ Gas _ Olher <br />PHONE <br />�^Ci�,vi\Ic <br />� (�Z7 � <br />g �i--U�' <br />0 %-Oa�-- <br />Z�t <br />3lo b loS� 0610 <br />CONTRACT PR�CE OF WORK <br />� <br />WORKUESCRIPTION ����� �X�£,{1��-� ���� W\��(l `('(�G\1��G���CI� <br />h�Y�(`�=- . <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavalory (wash basin) <br />Shower �� �✓ / <br />Kitchen sink 8 disposal Y-� <br />Dishwasher � �Q � � <br />Clolhes washer I <br />Water heater � 1 r,r., <br />Sink (service/bar/mop/etc.) � J�� <br />Backllow prevenler � <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease Irap <br />Root drains <br />Olher <br />� <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />lieat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Wor,dstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE �S 3105 <br />I hereby cerili(y lhal I have read and examined Ihis applicalion and know the sams to be Irue and correct. Ail provisions of laws and <br />ordinaces �overning Ihis type of work will be complied v�ith ��•hether specified herein or nul The granting o( a permit does nol presume <br />lo give authority to violate or cancel the provision of any other state or local law regulating consWction or the peAormance of <br />conslruction. Thal I am authorized by �he owner o� lhis property to per(orm lhe work for which application is made and I compry with the <br />Statc Conlractors La v 18.27 RC�V and 296.200 WAC. <br />-�� � � i; I �� �. `1���� 0� <br />Z <br />