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SITE ADDRESS <br />F :RMIT APPLICATI�_ N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — wrww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />PARCEL TAX I.D. 0 <br />Nc810-W3 <br />Iw <br />LEGA LOT NO. I BLOCK I TRACT OR SUBDIVISION N <br />DESC W 0Z70T `r4 k 5 I ;V 11 I CITY2IP PHONE <br />OWNER � ors. ADDRESS <br />DeI/In I.UI A501 nAlRcs Auc F„2(GII <br />TENANT NAME <br />CONTR. LICENSE N <br />USE OF BUILDING <br />-)Vf2 <br />WOR DESCRIPTION <br />jh R I <br />(AM0CU <br />V <br />HEATSOURCE <br />_]IlL Etcdric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />78. e720 <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basil) <br />Shower <br />Kitchen sink 6 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />— <br />_ <br />— <br />— <br />_ <br />— <br />_ <br />p <br />— <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX COUe rs srUo <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other slate or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and 1 comply with the <br />Stale Contra,Ctaq Law 18.27 RCW and 296.200 WAC. <br />