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SITE ADDRE55 • <br />�3.� p� � � c <br />LEGAL LOTf70. <br />DESC. <br />OWNER <br />�.,� Ci C�O � <br />TENANTNAME <br />P�tRMIT 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 />3/ � PARCEL TAX I.D. # <br />BLOCK TRACT <br />33s p/ <br />CONTACT�C <br />� <br />PERMIT# �- <br />�✓I l� � 5 - <br />3 s{�= <br />PHONE <br />3 <br />CONTRACTOR Z�r �i ��� �� ADDRESS I`'���� CITY21� PHOl� _���u/ <br />—l�f � T <br />CONTR. LICENSE # <br />USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br />� �/ >f Electric Gas Other 7' SG�� <br />/ �•G % / <br />WORK DESCRIPTION y�c��y�� �qc� �� j7i�i ,- %� � /(,t �Q� .�y %� ��G4� — <br />/ <br />tio-� � �t-.� <br />— PLUMBING <br />Np, I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Disliwasher <br />Clolhes washer <br />Water heater <br />Sink (service/badmop/elc.) <br />Backflow prevenlcr <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Othcr __ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />� Gas piping <br />� Water heater <br />i Gas fireplace <br />Gas range <br />Clothes drycr <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unil heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOC.4L SALES TAX CODE IS 3105 <br />I hereby cerilify thal I have read and exa ed tfjis application and know the same to be true and correcL All provisions oi laws and <br />ordinac o ning this rype of work be � mplied �vith whether specified herein or noL The granting ot a pem�it does not presume <br />to giv aulhority to violate c ce ie vision of any other state or Iocai law rec�ulating consWction or the pedormance of <br />co trucGon. Th t I ¢ b owner o( this property to perform lhe work tor which application is made and I comply with the <br />S te Conlr rs /�/�d 2. 0 WA� �/�/�G <br />