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SITE ADDRESS <br />1 �,� <br />LEGA LOT NO. <br />DESC. � �`) <br />OWN/ER <br />11 ,\h V 6''� <br />TENANTNAME ' <br />o. <br />0 <br />PERMIT 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 />PARCEL TAX I.D. # <br />, �1`i�'1y3 0�3`1�'l000�1�00 <br />BIOCK nTRACT OR SUBDI\VISION N <br />�ob `�-0O 1J0J�c�V .,�1���5 <br />�\ � n'� �: <br />I <br />wn i nwc wn <br />�,Jns��.tir,t�r ���i��n� ��s <br />CONTR. LICEMSE 8 <br />�_�G ca�-��r���`1�`� <br />USE OF BUILDING <br />.� � <br />CONTACT FOR PERMIT <br />�6�5 <br />� Uo <br />// ��O � <br />PERMIT # <br />:M //_. <br />PHONE ���.5' �.�.a. S o�3 <br />—T c�rnziP rnunt <br />S•�.o �� #�4 Lveresl �\�.S-3`�l-1��1�1 <br />HEATSOURCE <br />_ Electric � Gas _ Other <br />CONTRACT PRICE OF WORK <br />WOHKDESCRIPTION � �� �d�� ���V(�� ��1 rvt»e.�C ��r `�O�o ���}�1�'^1 C;�t <br />1�\ <br />i�. v��,�,��� 1Cuuw� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (servicelbar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <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 />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereuy certify lhat I have read and examined this application and krow the same to be true and correct. All provisions of Iaws and <br />ordinances goveming ihis type of work will be complied with whether specified herein or not. The granting of a permit dces not presume <br />to give authority to vioiate or cancel the provision of any olher state or local law regulating conslrudion or the performance of <br />construction. Thal I am authorized b�l�apwner of this property lo periorm the work for which application is made and I comply with the <br />State Contractors Lay,�18,2j�RCW and;296.200 WAC. <br />