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SITE ADDRESS <br />LOT NO. <br />P�r�MIT APPLICATIO�� <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. A� <br />��/o/5�1730 // <br />TENANT NAME I CONTACT FOR �ERMIT <br />�� � <br />CONTRACTOR p ADDRESS CITY2IP <br />� ✓"��Li� /��°�«"�2t`�YS /Oti''7 - '?.CC%�.�/ .�t/•l✓. ,JjGLnut2z�lv.Q <br />CONTR. LICENSE # <br />�i %�Tl� <br />USE OF BUILDING <br />.! <br />HEAT SOURCE <br />� Eleciric �Gas _ Other <br />PNONE <br />PHONE <br />�/7S -3y5 r 733 <br />CONTRACT PRICE OF WORK <br />2� <br />WORK DESCRIPT/ION /, .y /�� � �� <br />!,"'�)�y},"�C..i ilr"{t"�C�. � Ni't�l/� , �t['nai i2°'�''�; nl.�l` 7—�/�`-r rr�'v+�t.T+CQ^ <br />PLUMBING <br />N0. I TYPE OF FIXTURE OR ITEM <br />,� Toilol <br />L Bathtub <br />� Lavalory (wash basin) <br />Shower <br />� Kitchen sink & disposal <br />� Dishwasher <br />� Clothes washer <br />�_ Waler hea�er <br />Sink (service/bar/mop/elc.) <br />Backllo�v prevenler <br />Urinal <br />Drinkinc� Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Olhcr <br />MECHANICAL <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />�Range hood <br />Exhausi fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritity Ihat I have read and examined lhis application and know ihe same lo be true and cr�rrecL All provisions of laws and <br />ordinaces governing lhis type of work will be complied with whether specified herein or not. The gr nting of a permil does not presume <br />lo give authonty to violate or cancel the provision of any other state or local law reguiating consWclion or the performance of <br />conslruclion. Thal I am aulhorized by tho owner of Ihis properly to perform the work for which application is made and I comply with the <br />Sta�e Conlraclors Law 18.27 RCW and 296.200 WAC. <br />f�e �. '/ ../„�, <br />�/� <br />