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SITE ADDRESS <br />LOT NO. <br />?ENANTNAME <br />�i�M� T���. <br />PEkMIT 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 �p,,; <br />/ PARCEL TAX I.D. # PE I <br />� <br />BLOCK TRACT <br />ADDRESS CITY2IP PHONE <br />/j/'/ �IAInC`'�SPER��VI/AI�lYi- aC�`„r,3.r <br />CONTRACTOR /_�`�"j <br />,- � <br />CONTR. LICENSE # <br />USE OF BUILDING <br />WORK DESCRIPTION <br />,,. �� �.,,� y � o �D��3/ <br />�S-�' � K� <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />/�'Ne Si�J�'JNc���OaJ <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Showcr <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Waten c�ater <br />Sink (service/badmop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />cirrrziP PH <br />��(�ti'%�., <br />NO. <br />�� <br />CONTRACT PRICE OF WORK <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Ranc�e hood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Reirigeration <br />Woodslove <br />�� � , i I . � I <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify lhat I have read and examined this applicalion and know lhe same lo be true and correct. All provisions ot laws and <br />ordinaces governing lhis rype o( work will be complied with whelher specified herein or not. The granling of a permit does not presume <br />to give authonry lo violate or cancel the provision oi any other state or local law regulatinc� consWclion or the per(ormance ot <br />construGtien� Thal I am authorized by the owner o( lhis propeAy to pertorm the work for which application is made and I comply wilh the <br />