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SITE ADDRESS � <br />��2� <br />LEGA LOT NO. <br />DESC. <br />P�tZMIT APPLI�ATI(..J ���,,,� <br />CITY OF EVERETT PERMIT SERVICE �`���jCp <br />3200 CEDAR STREET, EVERETT, WA 98201 /1 <br />425-257-8310 — FAX 425-257-8857 — www.everettwa.org � � � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />o� J �� <br />, —� <br />..c �� �=-��� ir � <br />:NANT NAME <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION # <br />CONTACT FOR PERMIT <br />PHONE <br />RMIT # <br />(.x� i -O l <br />USE OF BUILDING � HEAT SOURCE � com KAc i rtcwt ur v�runn <br />WORK D SCRIPTION �� <br />���',��� woJl-� a <.v <br />C�_ V� C l N^aP C� l: C�'L � U(O <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />water heater <br />Sink (service/bar/mop/etc.) <br />Dackllow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />_ Electric _ Gas _ Other T�� a�(} <br />�� C—�� p��p;� �� <br />��� ciQixrt(k, <br />L�vi� A �fJr��a4Co-� <br />G `� �j � � K G �-Il� � U �.-I.k�% G7 <br />NO. I TYPE OF FIxTURE QR ITEM <br />A�C — air handling unils <br />i t � ;=orced air systems <br />Gas pipinQ <br />� Water heater <br />�Gas fireplace <br />Gas range <br />� Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiier <br />Retrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hemby cerlify lhat I have read and examined this application and know ihe same to be true and correcL All provisions of iaws and <br />ordinances governing Ihis type of work �,vill be complied with whether specified herein or nol The grenting of a permit does not presume <br />lo give euthorit to violale or ca�lthe provision of any other slale or local law regulating conslruction or the periomiance of <br />conslruclion°`�f iat I am aidhorized by t e owner of �his propeity lo periorm lhe work forwhich application is made and I comply with the <br />Slale,cC�OnU��.�iors L�w'1 27 RCW a�296200 WAC. , <br />// . '/� . _�� � . ��Y..n.�c� /d. ..LG'V <br />