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SITE ADDRESS <br />�1�L'"GAL LOT NO. <br />CONTR. LICENSE 11 <br />USE OF BUILDING <br />WORK DESCRIPTION <br />�e �-o c5-��- <br />PtRMIT APPLICATIVN <br />CITY OF EVERET� 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 />� lcec�\ <br />BLOCK <br />PARCEL TAX I.D. B <br />TRACT OR SUBDIVISION N <br />lVt\A'E --'• �l7« �ceely�C� 1-�i'�.1� <br />CONT T FO ERMIT � <br />�z� S ,r�.s��-���s �� <br />;g�,��-�n �- k'ci�- � � <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lava�ory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />W aler he2fer <br />Sink (servicelbadmop/etc.) <br />Backllow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />Eledric Gas Other <br />PERMIT �I <br />_ �� �5 -°3 <br />PHONE <br />`i82e3 '�i�-35S-774 � <br />��s'� �� ��Z� <br />� <br />-�513�,� <br />33�5_ <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FI%TURE OR ITEM <br />A�C — air handling units <br />forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhauslfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />I hereby ceritify lhal 1 have read and examined lhis application and know the same to be We and correcl All provisions of laws and <br />ordinaces governing this type o( work will be complied with whelher specified herein or not. The granti�g of a permit does not presume <br />lo give authoriry lo violale or cancel the provision of any other stale or local law regulating construction or the periortnance ot <br />conslruclion. Thal I am authorized by ihe owner o( Ihis properly lu pertorm Ihe work (or which application is made and I comply with the <br />Stale Contjj.lors Lawp (182 CWI an/�d 296.200 WAC. <br />/�� tl... �nlll � A�ll 9--� � �'v� <br />