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425-252-1fi66 CMNFATING <br />12:01 .16 p.m. 06-09-2014 2 /4 <br />� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX A25•257-�3857 — www.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM <br />SITE ADDRESS W <br />IND$ W MuKiLT�D <br />LEGA LOT NO. BLOCK <br />OESC. <br />OWNER <br />Rebecm, T��r f o r <br />7ENANTNAME <br />In� <br />USE OF BUIIDING <br />���5 <br />: ARCEL TAX I.D, it <br />TRACT OR SUBDIVISION lt <br />AOORE55 <br />�.aSG,ba,�� <br />COHTACT FOR PERMIT <br />bie <br />,,,,� eve.re# q <br />HEATSOUHCE <br />� Electdc �Gas _ Other <br />WORK DESCRIPTION <br />� Y15 iu 11 h��ti- �OU wLp �1- c0 i I �• <br />NO. � TYPE OF FlXTURE OR fTEM <br />Tollot <br />Bathlub <br />Lavatory (wash bas�n) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwashcr <br />Clolhes wa;hcr <br />Y�a1ar healer <br />Sink (service/barhnop/olc.) <br />Backllov+ provenler <br />Urinal <br />Urinkln0 Faunlain <br />Floor draln <br />' Gmaso trap <br />Root draln, <br />Olher <br />_g. <br />RMIT # <br />ZDl77 <br />�425Z59�66l0 <br />CONTRACT PRICE OF WORK <br />Io I I � OC� <br />N0. I TYPE OF FlKTURE OR ITEIA <br />A/C —alr handlin� uNts <br />Forced alr syslems <br />Gas plping <br />Waler haater <br />Gas lireptaco <br />Gas ranpa <br />Clolhas drycr <br />Range hood <br />Exhaustlan <br />Heat pump <br />Unit healer <br />Bollor <br />Relrlperallon <br />Woodslove <br />Olher <br />CITY OF EVERETT LOCAL SALES TNC CODE IS 3105 <br />I here6y cerlti(y thal I havo read and examtned Ihls appllcatlon and kno�v Ihe sama to te lrue and correct. All provlsions ol laws and <br />ordlnacos governing lhis typo ol work wlll be complled wllh whether spaclfled herein or no4 The granting ot a permi� daes nol presumo <br />lo give aulhorlly to vlolate or cancol iho provision al any ofher stale or towl taw repulating construction or lhe pertormance of <br />consVucllan. Thal I am aulhorized by thn owner of thls property lo perlorm Ihe work lor which appllcatlon Is mado and I cornply with Iho <br />Slato Convac�ors Law 18.27 RCW and 29G.200 WAC. <br />