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PERMIi APPLICATION <br />CiTY OF EVERETT PERMIT SERVICES S�a3-�3 <br />3200 CEDAR STftEET, EVERE7T, WA 98201 m � 3n s-0�(1 <br />425-257-8810 — FAX 425-257-885i — www.everettwa.org <br />APPLICATIONS ARE ACCEFTED FROM B AM TO 4 PM <br />SITe ADDRESS <br />� � <br />�FGA LOT NO. BLOCK <br />9ESC. <br />pWNER <br />lranc.l �ruc� <br />TENANT AME <br />. ��r�.�vV� �-1- <br />CONTR. LICENSE tl <br />F3l� r�,v,��.o. <br />USE OF BUILDING <br />WORK DESC TION <br />(-c._ <br />PARCEL TAX I.D. M <br />TRACT OR SUODIVIS10N • <br />. CONiACT �OR PERMIT PHONE <br />�Q,l fl'U � � C7�Ci11.1�.J-.Ii _'_'.. <br />i 1 `j I��Vy� CITYlZIP P <br />rL ��.+���. <br />������; <br />HEAT SOURCE <br />Electric�a; _ Other <br />Cj 0. � kU Y 1'lA C.-�, <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />�athlub <br />_ Lavatory IN'nsh basin) <br />Showef <br />Kitchen sink 8 di;posal <br />Olshwaeher <br />� Cloth�s washer <br />� Water heater <br />� Sink (seMpe/parlmop/etc.) <br />� BackOow p�venter <br />Unnal <br />Dnr.king Fountain <br />� FIOOf tlfciiil <br />_ Greasetrap <br />Roof drains <br />� Other „ <br />PERMIT p <br />�� <br />��� d a F �A od ��� � <br />CONTRACT PRICE OF WORK <br />N0. � TYAE OF F�XTURE OR ITEM <br />A!C — alr handling units <br />� Farced air systems <br />__ Gas piping <br />water ne0ter <br />^ Gas freplace <br />,_ Gas range <br />_, Crothes tlryer <br />� � Range hood <br />_ Exhausifan <br />� Neet pump <br />, Unit reater <br />� Boiler <br />_ Refrigeration <br />_ vVoodstove <br />� Other <br />CI1Y OF EVERE7T LOCAI, SALES TAX CODE IS J705 <br />1 hereby certdy (hat I have read and ezamineN this appiication and know the same fo be true and corred. All pwvisions ot laws antl <br />ordinances goveming this tyF' o� �^+orh will be conplletl with whether specifietl hereln or not The granling of a perm�t does not presume <br />to give authonty to vlolate or c,3ncel the provision �f any other stale or Iocei law regulaling constructioo or ;he performance of <br />constPuct�on. 7ha1 I em authori�ggqtl by Ihe owner ot 1h15 property t0 perterm thC wprk rOr whiCh appiiCdtion is made and I comply with thC <br />State�oNraUors Law 18,27�(�JV 2nd 2 6.20� WAC I_^ I <br />I <br />