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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVER[TT, WA 98201 <br />425-257-881 D— �AX 425-257-8857 — vnvw.everettwa.org <br />SITE ADDRESS <br />�3� �� <br />LEGAL LOT NO. <br />DESC. <br />flovJi��� <br />TENANT NAME <br />�q��E <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />PARCEL l'AX I.D. # <br />l_G�j_ oov - � a�� <br />TRACT OR SUBDIVIS�ON Y <br />� s/�T� ��FGy�v�- � <br />l;un � rtr��. � ��� <br />�'���E_'FTi f�'i�/i�L Avi/���' <br />CONTR. LICENSE # <br />USE OF BUILDING <br />5�.� <br />2�1 - <br />��,��G3. /�l % <br />COIJTACT FOR PERMIT PHONE <br />n� �✓���. �Z.T.�L�d�, l5 % �b <br />i EddAIL <br />HEAT Sq11RCE <br />_ Electric i Gas _ Oiher <br />WORK DESCRIPTION <br />���/���f4/�/�� �.�/,�/%//� .E'�s/QE-i�CE <br />NO. I TYPE OF FIXTURE OR ITEAi <br />Toilet <br />Bathtub <br />Lava!ory (v+ash basin) <br />Sho�ver <br />Kitchen sink & disposal <br />Dishx�asher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mopletc.) <br />Backflo�v preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NTRACT PRICE OF WORK <br />11 �,� (� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas freplace <br />Gasrange <br />Clolhes dryer <br />Range hood <br />Exhausttan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretinn <br />Woodstove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be lrue and correct. All provisions of laws and <br />ordinancas governing this type of work v�ill be complied with whether specified herein or nol. The granting of a permit does not presume <br />to give authority to violate or cancel the provision o( any other state or local law regulating conslruction or the performance o� <br />construction. That I am aulhorized by the owner of this property to perform the worF: for vrhich application is made and I comply with the <br />Slale Cyvyra ors�w 18.27 RCW and 296.200 WAC. <br />// ,�1�� 1��►1 <br />