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PE�cMIT APPLICATi01�v <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everetriva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />,,-,; C i ,���, <br />LEGA L07 N0. <br />DESC. � C <br />PARCEL TAX I.D. A <br />�'1-0 . oa�s24 0 0 7 0/ oo � <br />BLOCK TRACT <br />Z <br />� <br />�.'�� R-�,o��� 7z3 93'� 5,—, S,� �,frzer�- 2��9g19 <br />TENANTNAME CONTACTFORPERMIT � PHONE <br />N�+- � �� �-, o���. �yo--9e� 9 <br />CONTRACTOR AODRESS <br />1�c8 �vNs�,z,,,�,—,c� <br />CONTR. LICENSE # <br />USE OF BUILDING <br />SF 2 <br />WORK DESCRIPTION <br />�►Mcv� FX. J�5 � <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drein <br />Grease trap <br />Root drains <br />Other <br />HEATSOURCE <br />� ElecMc <br />Gas _ Other <br />CITY2IP PHONE <br />CONTRACT PRICE OF WORK <br />/O�o °= <br />i <br />TYPE OF FIXTURE OR ITEM <br />AIC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woadstove <br />Other <br />CITY OF EVERETT LOCAL SALES 1'AX COUE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and cortect. Ail provisians of laws and <br />ordinaces �overning this type of work will be comolied with whether specified herein or not. The granting of a permit does not presume <br />to give ority to violate or cancel th provision of any other state or local law regulating construction or the performance of <br />const ctio . That I am autho by he owner of this property to peAorm the work for which applicatlon is made and I comply with the <br />Slat Cont crors d 296.200 WAC. <br />ll�lil�� �. 9- o�'o� <br />