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SITE <br />LOT <br />CONTR, LICENSE / <br />USE OF BUIIDINO <br />-� � <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.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />DE8CRIPTION�r � �� � ( � � <br />N0. � TYPE OF FIXTURE OR ITEM <br />Toflet <br />BelhWb <br />Lavalory (wash besin) <br />Shower <br />Kilchen sink & disposel <br />Diahwaeher <br />Clolhes washer <br />Laundry Vay <br />Sink (servicelbadmop/etc.) <br />Backflow preventer <br />Urinal <br />Orinking Founteln <br />Floor drein <br />Grease trap <br />Roof dralns <br />Other <br />PARCEL TAX I.D. Y <br />� <br />CITY/ZIP <br />S-a3-o� <br />PERMIT It <br />PHONE <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />�Eler,tric _ Gas _ Other � ��--��" ' " <br />i���{°�D�'����� ll� ��If/i i%L)U�iifPCl� Ui����. <br />v <br />N0. I TYPE OF FIXiURE OR ITEM <br />A/C — air handling units <br />Forced eir systems <br />Gas piping <br />Weter heater <br />Gea fireplace <br />C,ea renge <br />Clothes dryer <br />Range hood <br />Exheustfen <br />Heat pump <br />Unit heater <br />Boller <br />ReMgeratlan <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL 9ALE8 TAX CO�E �8 �106 <br />I hereby ceritify lhat 1 heve read and exemined thls epplication and know the seme lo be true and wrred. All provislons of lews and <br />ordinaces goveming lhis type ot work will be complied with whelher speGfled herein or not The grenting of e pertnfl does not preaume <br />to glve authority to violate or cancel the provision of any other stete or local lew reguleGng construcNon or the peAortnence ot <br />construcUon. Th t'j em euthorized by the owner of this property to pertortn lhe work for whlch eppllcaGon Is mede end I comply wilh the <br />Stete Con�racto�,Qaw 18.27 RCW and 296.200 WAC. _. � � , <br />i <br />�� <br />