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SITE ADDRESS <br />2�LI � <br />LOT NO. <br />IO � <br />P�RM�T 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 />PARCEL TAX I.D. # <br />9Z- P�V� Oo�O I�i4�4�Zo1 � <br />BLOCK TRACT OR SUBDIVISION it <br />I-bM� IN� . <br />TENANT NAME - CONTACT FOR PERMIT <br />- �J� - i ��, � K�� <br />�6RfiFA� pU�1JQ'L�fdill/C�i-rn— bft€�� A�`� ^ <br />i �vKJ <br />CONTR. LICENSE # <br />KE�asN�Toos�� <br />USE OF BUILDING <br />R�l � VNG� <br />HEATSOURCE <br />_ Electric � Gas _ Olher <br />WORK DESCRIPTION <br />, �u.bn� iJ�u� �R�u-� li-� ��`sT►rc,Ct- E-IoUS� <br />��.� �i��-3�kdDf11�+-�`70 �kcl� o� {�sE <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilc� <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwashcr <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinkinc� Founlain <br />Floor drain <br />Greaso lrap <br />Roo( drains <br />Olher <br />NO. <br />� <br />PHONE � <br />e.Ma� <br />CONTRACT PRICE OF WORK <br />�-o� �e.� r�7 e�.�►-� <br />TYPE OF FIXTURE OR ITEM <br />A/C - air har.dling units C� c� <br />Forced air s�stems � <br />Gas piping 1 � ` <br />Water heater — �n! C"�� <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhausl tan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodsto�e <br />Other <br />p�'SiA � <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerili(y thal I have read and examined this application and know lho samo to be true and correct. All provisions ot laws and <br />ordinaces c�overning lhis lype of work wiil be complied w�ith whelher specifiod herein or not. The granting of a permil does not presume <br />lo give aulhorily lo violato or cancel lhe provision of any other state or local law regulaling constructlon or ihe pedormance of <br />construction. T�al i am aulhorized by lhe owner o( lhis property to perform lhe work for which application is made and I comply wilh Ihe <br />State Cop¢ac rF'Law 18.7� RCW and 296.200 WAC. <br />�/ <br />(� <br />