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� <br />PERMIT APPLICATION o�(� � �-� <br />CIT1i' OF EVERETT PERMIT SERVICES �� C' ��lL <br />3200 CEDAR STREET, EVERETT, WA 98201 f_� �;' 20Qg <br />4?5-257-8810 — FAX 425-257-8857 — wuvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L�T�� �F EVERE�j�r ' <br />En��-;, .,,..._.� . <br />S1TE ADDRESS <br />aao5 DK4}NamA f�v� <br />LEGA LOTNO. BLOCK <br />� <br />TENANTNAME <br />'v � <br />PARCEL TAX I.D. � I PERMtT i <br />asti�2000��ood Mr�r,. <br />iRAC70H SUBqVI&ON / <br />FOA PERMR <br />CRYZP PHONE <br />rLi� <br />9p�1 8o�-yo� ayF�� <br />P►,o� .�� ��-�,� <br />.................. . .... ...... . ....�..: � _ <br />� a.s�hN��-. Ww �' a �S /�� R,���,� ✓lcr� i�- - <br />1,� �+-r ��9sa o � ���[e� � (,�a yaao s � �-�58 � <br />USE OF BUILDING HEAT SOURCE � <br />I I ��RACT PRICE OF WORK <br />WORK DESCRIPTIbI: <br />I_ Eleclric ✓Gas _, Other I �� O <br />C�G�f'l yG DICf C�aS 1�-�attva���K <br />NO. I 7YPE OF FlXTURE OH ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbadmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease Irap <br />Rool drains <br />O�her <br />NU. I TYPE OP Fl%iURE OR ITEM <br />A/C—air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas tireplace <br />Gas renge <br />Cbthes dryer <br />Rangetrood <br />Exhaustfan <br />Heatpump <br />Unit hea�er <br />Boiler <br />Refrigeration <br />Woortstwe <br />CITY OF EVEaETT LOCAI. SALES TA% CODE IS 310.5 <br />I hereby ceritify that I have read and ezamined this application and know the same to be hue and cortect. All provisions o( iaws and <br />ordinaces goveming Ihis type of work will be complied with whether specified herein or not. The granting ol a pertnit does not presume <br />to give authority to violate ar cancel the provision of any o[her state or local law regulating construction or the perfo�mance of <br />construclion. That I am authorized by the owner of this pmperty lo peAortn the work for which applicatlon is made and I comply with Ihe <br />Stale Coniractors Law 1827 RCW and 29620D WAC. <br />2- <br />