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PL�MIT APPLICATI�� <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 - DEBIT d� CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />d iflfstiDl�ian� /�D� <br />LOTNO. BLOCK <br />� <br />PARCEL TAX I.D. A <br />TRACT <br />%�AC� // <br />zSOr 2Na p„B A' <br />TENANT NAME I CONTACT FOR PERMIT pHONE <br />CbRS `%A�L %l!•�'✓P!?c7u�.J9 S�r� /�E'C,e�so� za� -'7$6 tz9� <br />CONTRqCTOR r"" ADDRES CfTY21P PHONE <br />/�hi�.r*�,�rc- Z:.t�s3 �d..�Eue�eK .Ss�,� c42s)9b'b- <br />CONTR.LICENSEk �N/�A4EZ�8///L�% �"'��//i c•'� 9daa� /�/Z7//� �f�,Z7 <br />USE OF BUILDING <br />D1�� /c✓!/� u :LC � <br />WORK DESCRIPTION <br />�� � � —r.,�-o n( P �-.� <br />'��I S . <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Ciothes washer <br />Laundry tray <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinai <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ <br />HEAT S�BSY� <br />Electric ther <br />CONTRACT PRICE OF WORK <br />�/�o. $a� <br />'�o�-ro� v+�1�=�5 �lW D 3 ExNa.,s-r <br />NO. � TYPE OF FIXTURE OR �TEM <br />AIC — air handling units <br />Forced air syatems <br />Gas piping <br />Water heater <br />Gas fireplace <br />uasrange <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />UNt heater <br />Boiler <br />Refrigeradon <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3703 <br />I hereby ceritify that I h e read and examined this applicatlon and know the same to be true and cortect. All provisions of laws and <br />ordinaces �ove g t s type of work will be complied with whether spscified herein or not. The grantlng of a permit does not presume <br />to give authon vi te or cancel the provision of any other state or local law regulating consWctlon or the performance of <br />construction. I authorized by the owner of this property to perform the work forwhich application is made and I comply with the <br />State Cont .1A.27 RCW and 296.200 WAC. <br />