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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 />SITE ADDRESS <br />0 ulc: F <br />LEGAL LOT N0. <br />DESC. I <br />OWNER <br />.]oc�� � r��/Mel��ca <br />TENANTNAME <br />(�C„ �he�' <br />CONTR. LICENSE p <br />USE OF ILDING <br />S; 1� , �,M.\y <br />�:��n� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />���� �,fA PARCEL TAX I.D. # <br />,� qgl 50S$pOOo 1�101 <br />BLOCK TRACT OR SUBDIVISION # <br />CONTACT FOR PERMIT <br />�ioe.� Co�rptr- <br />HEATSOURCE <br />k Electric _ Gas _ Other <br />4�.5 �3�-o65a. <br />CONTRACT PRICE OF WORK <br />� 250 0 <br />WORK DESCRIP710N � . � Co�,� �.o�+ Por�}, <br />�lclos ih5 Qn ex,s���� <br />NO. I TYPE OF V TURE OR ITEM �/' " <br />Toilel � <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Cbthes washer <br />Walen c�ater <br />Sink (service/bar/mop/elc.) <br />DackOow prevenler <br />Urinal <br />Orinkinc� Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. <br />FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gasrangc <br />Clothes dryer <br />Rango liood <br />Exhausl (an <br />Hcal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br />� <br />I hereby ceritify thal I have read �nd examined lhis applicalion and know the same lo be true and correcl. All provisions of laws and <br />ordinaces c�oveming this type of work will be complied with whelher specified herein or nol The granting of a permit does not presume <br />to give authority �� violale or cancel the provision of any other stale or local Iaw regulating consWction or Ihe performance of <br />construction. Thal I am aulhorized by lhe owner of this property lo perlorm the work for which application is made and I wmply with the <br />Slate Coi}Ira 'prs'Law 18.�j RCW and 296.200 WAC. <br />��Z <br />