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SITE ADDRESS <br />LOT N0. <br />DESC. <br />I��RMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. X <br />— />n /_ nrr�nnn G <br />io�do-o6 <br />PERMIT # <br />TENANTNAME ' COflTACTFORPERMIT " PHONE <br />L/:*1 � . I 77 � e_ !� �P'�-e �,ZS = .�C�S—�o5—�7 <br />�v°"F�`�cL1T /hws,',�(J.� ,4u�<�e�C�� 3%o7ca/�y� Qv� g�3�lP �/,�-s�—G�/ 7 <br />CONTR. LICENSE N • <br />USE OF BUILDING <br />W ORK QESCRIPTION K G PL\ 1� <br />HEATSOURCE <br />Electric �Gas Other <br />�t� es,u�(c 1 CXr`yf-i �.�, �'c5� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BathWb <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barlmop/etc.) <br />BackOow proventer <br />Urinal <br />Drinkinc� Founlain <br />Floor drain <br />Grease lrap <br />Roo( drains <br />Olher <br />CONTRACT PRICE OF WORK <br />c c c ��/lifc-�n-/ t <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />� Gas piping <br />� Water healer <br />Gas fireplace <br />Gas range <br />�Cblhes dryer <br />Range hood <br />^� Exhaustfan <br />Heat pump <br />Unil healer <br />Boiler <br />Refrigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby cerilify that I have read and examined this applicalion and know the same to be lrue and correcL All provisions oi laws and <br />ordinaces governing lhis type of work will be complied with whether speci(iod harein or not. The granting of a pertnit does nol presume <br />to give aulhority lo violate or cancel lhe provision ot any other state or �ocal law rctgulating construclion or lhe perfortnance of <br />construclion. That I am authorized by the owner of this property to paAorm ihe work (or which application is made and I comply with the <br />State�Contractors Law 18.27 RCIy and 29G200 WAC. <br />