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( L <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />I 3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />SITE ADDRESS <br />�9�� <br />LEGA LOTNO. <br />DESC. <br />NAME <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���3-- I� G5 <br />�,� u�� <br />BLOCK <br />�-n10E(�� OnI <br />PARCEL TAX I.D.1! <br />�nyzx�'3.�4o�Y�� <br />TRACT OR SUBDIVISION K <br />I91� RR��IE2 A✓E <br />CONTACT FOR PERMIT <br />�L�E FCRhC <br />Ev�2e�- qYao, y�s--zsZ-9� b'f� <br />PMONE <br />--�s-3�i �i39 <br />.................. -.__..__ w x _...._.. ( �..._.._ <br />�,i vE F+..�rrn F_ +-�c• ?�� ln z.i e� S! . I movn+bx¢k+�a� iEUV. 4a5-'�?�-7i3`l <br />CONTR. LICENSE N <br />BwEc�va��rz� <br />USE OF BUILDING <br />WORK DESCRIPTION <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />�P � <br />_ Eleclric Gas __ Other � ,r� <br />�u�Zr✓A�ce C�FAnl6�0✓r <br />ND. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavatory (wash basin) <br />Showe� <br />Ki�chen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Walcn c�alcr <br />Sink (service/bar/mop/etc.) <br />Oackfly d preventer <br />Urinal <br />Drink� ig Fountain <br />Floor drain <br />Greasc trap <br />Roof drains <br />Othcr <br />N0. <br />TYPE OF FIXTURE OR REM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas tireplaco <br />Gas range <br />Clothes dryer <br />Ranga hood <br />Exhaustfan <br />Hcat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />other GAS F�Rj.IA� <br />CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceriti�y that I have read and examined thfs applicalion and know Ihe same to be lrue and correct. All pravisions ol laws and <br />ordinaces governing Ihis lype ol work will bo complied wilh whe�her specified herein or not. The granting of a permil does not presume <br />�o c�ive aulhority to violate or cancel lhe provision ot any olher stato or local law regulating construction or Ihe peAormance of <br />constr.�ction. That I am aulhorized by Ihe owner of this property to peAorm the work for which appt(cation is made end I comply wilh the <br />Slatc Conhactors Law 18.2�CW and 296.200 WAC. <br />