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SITE ADDRESS <br />I 3 �I ► <br />LEGAL LOT N0. <br />oesc. Z 3 <br />P�.�MIT APPLIGATIG. � <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everetlwa.org <br />APPL ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />i�TFo �va oosos�0000'z3 � i <br />BLOCK TRACT OR SUBDIVISION # <br />M,4PLr tf �1 L� FF 7'S <br />u�s. <br />ERMIT N <br />1... n �+ <br />s��/E �/ SA�IIC� Ti4C(.MAti! l 3�// MuKi�rr:� 6Cv.�, �v��t�z,'�' <br />TENANT NAME CONTACT FOR PERMIT PHONE yzS- 34y-S3S3 <br />TOtii�/ L��IS E•MAILL(�MISCON�f� Co�n <br />C TRACTOR ADDRESS CITYIZIP PHONE <br />coNra cpM1aS C�/SMu�T10,�/ �/920 ��09 �' yZs�3vy-S3s,� <br />GooNil C�' 16q P� ��vr_- ��, S,�IoN�M�St-I �-9 9i3 29-0 <br />USE OF BUILDING HEAT SOURCE <br />�,q (LA (�r—` I _ Lleclnc _ Gas _ Other <br />WORK DESCRIPTION <br />N � �✓-- � <br />\_� <br />Np. � TYPE OF FIXTURE OR ITEM <br />� <br />� <br />� <br />1 oilet <br />aau�i�� <br />Lavalory (wash basin) <br />Shnwer <br />Kitciien sink 8 disposal . <br />Dish�vastier <br />Clothes �vasher <br />Water heater <br />Sink (servicelbadmop/etc.) <br />4ackliov+ pi eventer <br />Urinal <br />Drinking Founlain <br />Floor dram <br />Grease trap <br />Roof drains <br />Olher <br />0 <br /><- <br />CONTRACT PRICE OF WORK <br />Oc'�O <br />=��-Ga��e— <br />NO. I TYPE OF FIXTURE OR ITEM <br />A!C — air handGn� units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas Greplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhausl (an <br />Heal pump <br />Unit heate� <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 9705 <br />I hereby certify thal I have read and examined this aUPli;;alion and know the same lo be Uue and correct. All provisions of laws and <br />ordinances govemi g lhis type of woik will be complied wilh whether specifed herein or nol The granting of a permit does nol presume <br />lo give authorily� lo clale or cancel the provision ot any olher stale or local law regulating consirudion or ihe periormance of <br />conslruction. That I� n authorized by ihe owner of this property lo perform the work for which application is made and I comply riith the <br />Stale Conlrac�ois L 1827 RCW and 296 200 WAC. <br />_ 31�z1�� <br />