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P�RMIT APPLICATI��V <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org /,�OS J� <br />�� <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM - DEBIT i CREDR CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />Restroam at 14th Street <br />LEGA LOT NO. <br />BLOCK ( TRACT <br />Port of Everett P. 0. Box 538 Everett, WA <br />TENANTNAME <br />PARCEL TAX I.D. N <br />CONTACT FOR PERMR <br />PHONE <br />i`bl�2 0 POII LU15 �j-�-�j,� <br />CONTRACTOR ADDRE33 CITY2IP PHONE <br />CONTR. LICENSE X <br />USE OF BUILDIN(3 <br />R25t►'OQII <br />HEATSOURCE <br />_ Electdc _ Gas _ Other <br />WORK DESCRIPTION <br />Demlition of stnxture fa^ the 14th St. Bulkhead replacenent proje;,t. <br />NO. � TYPE OF flXTURE OR ITF.M <br />Tcilet <br />Bathtub <br />Lavalory (wash basfn) <br />Shower <br />Kitchen sink � dlsposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/baNmop/etc.) <br />Backflow preventer <br />Urinal <br />Ork�lcing Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />� <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FD(TURE OR ITEM <br />AIC - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas Flreplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust han <br />Heat pump <br />Unit heater <br />Boiler <br />Refriperadon <br />VI'oodstove <br />CITY OF EYERETT LOCAL 9ALES 7AX CODE IS �105 <br />I hereby ceritly that I have read and exemined this applicatlon and kraw the seme to be true and cortect. All proNsiona oi laws end <br />ordinaces goveming this lype of work wlll be complied with whether apedfled herein or not. The grantlrp of e pertnit does rat presume <br />to give authority to violate or cancel the provislon of any other state or bcel law repuladng constructlon or the peAortnanoe of <br />consWctfon. That am authorized by the owner oF th�a property to perform Ihe work for whfch appliratlon Is made end I camply wNh the <br />State Contractors a 7 RCW and 296.200 WAC. <br />