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SITE ADDRESS <br />�ESC <br />LOT N0. <br />F'CRMIT APPLICATIVN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-&810 — FAX 425-257-8857 — wvwv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. q <br />2 �- S`-o5 <br />PERMIT # <br />/�, SI �� ` �=_ <br />f/ <br />��'7 �-,�r�x�lE.1�nJ <br />CONTR. LICENSE # / .T-7 �Z �� <br />VJv � <br />USE OF BUILDING <br />�c�tl��. ��C�nlj <br />WORK DE�CRIPTION <br />CONTACTFOR <br />i��2 ru <br />3 .&alka-� <br />HEATSOURCE <br />Eleclric � ` Gas _ Olner <br />CPCNiN� �:�- ��12��'� �-cr�riCr� �N�SE 1�'N I NCry �1r2��} <br />NO. I TYPE OF FIKTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />c�ou,es Washer <br />Water healer <br />Sink (service/badmop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />PHON��,��3�,-sy�l <br />CONTRACT PRICE OF WOFK <br />�' �,2C,� E'° <br />N0. I TYFE OF FIXTURE OR ITEM <br />NC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplacc <br />Gas range <br />Clothes dryer <br />_ Range hood <br />_ Exhaust (an <br />_ Heat pump <br />Unit heater <br />Boiler <br />Retrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�`k <br />I hereby cerili(y lhat I have read and examined lhis application and kno�v the same lo be lrue ar,d correcl All provisions of la�ss and <br />ordinaces governing lhis type o( work will be complied with whelher specified herein or not The granting of a permil does not piesume <br />lo give authonty lo violale or cancel lhe provision o( any other state or local la�v regulating consWclion or the performance o( <br />construction. Thal I am authorizr�l by Ihe owner of this property to perform lhe work for which applicalion is made and 1 comply with the <br />State Contraclors La 18.27 RCI. and 00 WAC. <br />-�l'f.LL��� - / z -a s�-os <br />