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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 />SITE ADDRESS <br />S I 3v l�/R,�6�'�1� At(G <br />LEGAL LOT NO.��/ BL�CK <br />DESC. �'�� ���j[%}�^ <br />TENANTNAME <br />�� �^ � <br />IPARCEL TAX I.D. # <br />29�"i3.5�;�3 300 <br />TRACT OR SUBDIVISION p <br />�_���oc <br />��o5o�-vyo <br />U� U� <br />�����„ �,..,_., ..._.._ yyS <br />5� 3o N,s,�'.�� AVL Ev�'�-rl, w.S �8?03 q; <br />ENb��y <br />CONTR.LICENSE# ('L{�LIQAESOIJ�J-� J <br />J <br />USE OF BUILDING <br />5 FQ- <br />CONTACT FOR PERMIT <br />� ����,8 N��n� <br />/C 3Q A/!V � �,�//;. �o// <br />�f�-S- y�i-9l� <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />_ Electric J�Gas _ Other � Z � S / - �� <br />WORK DESCRIPTION <br />/IF���'��ti�u Ex�s�nNV ��'� Fd,Gr�A<F ,tn/Q AAGiti� N6Gu NFiS� C�/'^P <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavarory (wash basin) <br />Sho�ver <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink �service/ba7mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Foun�ain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FI%TURE OR ITEM <br />NC - air handling units <br />Forced air syslems ((.•l�i' `U���) <br />Gas piping <br />Water heater <br />Gas (ireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceritily that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces gov?ming this type ot work will be complied with whether specified herein or noL The granting of a permit does not presume <br />to give a ori to violale or cancel the provision of any other state or local law regulating consiruction or the perormance of <br />construc o l iat I am authorized by the owner ol this property to perform the work for which applicalion is made and I comply with the <br />State C n r Law 18.27 RCW and 296200 WAC. <br />r I ��, �-�-�'�� <br />