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SITE ADDRESS <br />��_/� <br />i Ff:AI LOT NO. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — wv�nv.everettwa.org <br />ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # PERMIT # <br />�l Z - DU�- ODO -DOd � ��� <br />BLOCK � TRACT OR SUBDIVISION: <br />ADDRtSS <br />�yoz��ii✓� ��TH���r/ 3i��� C�c�y �d� �d��'-� y2s. 3a3. /iZ/ <br />R,l-'� o / <br />TENANT NAME <br />F 6�c /�E// �/G�/.I�//i/6 a �/Tf�o�/' / <br />CONTR. LICENSE K <br />USE OF BUILDING <br />v / /� <br />CONTACT FOR PERA5IT <br />.��✓i✓cFF <br />HEAT SOURCE <br />Electric ��as _ Other <br />PHONE <br />y2s s v� E3 �u <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />,�r��I/�C�/���i�GE-� �Xif�ir�✓G ��s/�'�/C'� <br />NO. I TYPE OF FIXTURE OR ITEA7 <br />Toiiet <br />Bathtub <br />Lavatory (wash basin) <br />Sho�ver ' <br />Kitchen sink 8 disposal <br />Disherasher <br />Clothes washer <br />VVa�er heater <br />Sink (service/bar/mop/etc.) <br />Back`lov+ preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greas? trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEt.1 <br />A/C — air handling units <br />Forced air sys!ems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Ranaehood <br />cxhaust fan <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby cerlify thal I have read and examined this application and knova the same to be true and correct. All provisions oi lav+s and <br />ordinances governing this lype of work will be complied witn whether specified herein or not. The granting of a permii does not presume <br />to give authority ro violate or cancel the provision of any other slate or local law regulating construction or the performance ot <br />constru ion. That i am authorized by the owner of this property lo perform ihe work tor vrhich application is made and I comply with the <br />��-,�„ � a:lors Law 1827 RCW and 296200 WAC. <br />i�e �nedConlractodAuthorized Agent <br />