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SITE ADDRESS <br />LOT N0. <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 />��I <br />BLOCK <br />� i/C,L'� %% ffOu.S/ti/� �TL�rl��i <br />TENANTNAME <br />iV � f} <br />i�, /NG <br />CONTR.LICENSEI ��L��.ez t�"�I�`�BQ <br />y <br />USE OF BUILDING <br />PARCEL TAX I.D. A <br />TRACT OR SUBDIVISION R <br />_ 27�r /�ji4�J'N�� L� <br />CONTACTFOR PERMIT <br />A R t� ULJ� �%i'� <br />�S�cr,k.�G��Ti <br />HEATSOURCE <br />✓Electric ✓Gas Olher <br />PHONE <br />���bl,sf rl <br />�P�UU, y <br />`J—�7 <br />IT M <br />b7 �D� <br />��zs-�3 -�i� <br />3�l_� <br />�/z�/- 7�/j <br />CONTRACT PRICE OF WOIiK <br />WOHK DESCRIPTION //}��,,/�. /�F'..��7 6x�GJ S�L(l�.YC%�-F ,' P�lJV/GL� N'e-•-J C��� , <br />�,N�� �v a 4. ,=, y�y �.,��� �sts w.: rr���� <�('y �F. ���PE ��' u,o 2�c �S'f�2,,,.;�� <br />NO. I TYPE OF FIXNRE OR ITEM <br />Toilet <br />Bath�ub <br />Lavatory (wash basin) <br />Shawer <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backllow preventer <br />Urinal <br />Drinking Foun�ain <br />Floor drain <br />Grease trap <br />Rocl drains <br />Olher _ <br />NO. I TYPE OF FI%TUNE OR REM <br />A/C – air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clathes dryer <br />Range hood <br />Exhaustfan <br />Heat oump <br />Unit heater <br />Bailer <br />Relrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAII CODE IS 31Q5 <br />I hereby ceritily that I have read and examined this application and know the same to be true and correct. All pravisions ol taws and <br />ordinaces governing Ihis lype ol work will be complied with whelher specilied herein or not. The granting ol a permit does not presume <br />to give authority to vioiate or cancel the pro��isiori ol any other stale or local law regulating construction or the perlormance of <br />construction. That I am authorized by the owner of lhis property lo perform Ihe work lor which apptication is made and I comply with ihe <br />Slale Conlraclors Law 18.27 RCW and 296.�00 WAC. <br />