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SITE ADDRESS <br />5 - a <br />LEGA LOT NO. <br />TENANTNAME <br />��U / <br />CONTR. LICENSE <br />' SHC�c <br />USE OF BUILDING <br />PERMIT APPLICATION <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 7�-�6 —I � <br />BLOCK <br />PARCEL TAX I.D. N <br />�O�o s-�pODoD90n <br />' �1���— i�r►R.����- �A1+ EI/ERf."1f <br />� CONTACT FOR PERMIT <br />PERMIT A <br />-1 . u �� - c��i <br />r �� <br />DRE55 GITY/ZIP PMONt�o/^q�/�, <br />I 7�� <br />�oo E n���r� S'T.' VI�1���F 9S�7�Z <br />HEATSOURCE <br />,�Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />� � 2,248, r <br />WORKDESCRIPTION ���I`4e�. �'�iSTlf�l`v �(fl%U `� FUR-�/��E W�� �� <br />E�►�FJ ��' c�►.�T C���q-S Fi� 2N A �E � � � S �-}-'�.A� P U r1 � F�J l� d^� • <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Dnnking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />N0. I TYPE OF FIXTURE 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 />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS J105 <br />I hereby certify thal I have �ead and examined lhis application and know the same to be true and corcect. AI� provisions of laws and <br />ordinances governing this type o( work will be complied with whether specified herein or not. The granting ot a pertnit does not presuma <br />to give authority to violate or cancel the provision ot any other state or local law regulating construction or the perfortnance of <br />wnstruction. That I am authorized by the owner of this property to peAorm the work for which :,pplication is made and I comply with the <br />State ContraG�ors L3y� t�and ::96.200 WAC. � � <br />%'lJ �l l2�l7aJ 10 <br />