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SITE ADDRESS <br />LOT N0. <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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. k <br />Bl.00Y I TRACT OR SUBDIVISION k <br />PERMIT K <br />�InnG - �6 <br />.�w�G"�' TC0.G ��111 1.�.�rc•t w eur �VtCGi-F 9f32G�� <br />TENANT NAME � CONTACT FOR PERMIT PHONE[}2�i�<{03 •O�O <br />NAMG Uta �� c (" <br />CONTR. LICENSE �I <br />USE OF BUILDING <br />WORK DESCRIPTION <br />QJ,Id o. l6' x z2' c-o.�'poc+ <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilei <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Ciothes washer <br />Water healer <br />Sink (servicelbar/mop/etc.) <br />Back9ow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />l':n� <br />�c.K 1. � c <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric _ Gas _ Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />� <br />� <br />� <br />A/C �• air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplaca <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust tan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know ihe same to be true and corred. All provisions of laws and <br />ordinances governing this type of work wili be complied with whether specified herein or not. The granting of a permit does not presume <br />lo give aulhoriry lo violate or cancel the provision of any other state or local Iaw regulatin� consiruclion or the performance of <br />construclion. Thal I nm authorized by the owner of this property to perform the work for which application is made and I wmpiy with ihe <br />State CoNractore Law 1827 RCW and 296200 WAC. <br />- aa- o <br />Dale j/� <br />� <br />