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d <br />SITE ADDREBS <br />LOT N0. <br />� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 —www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />PARCEL TAX I.D. it <br />� I � <br />BLOCK TRACT OR SUlOIVI610N t <br />RE CITY2IP <br />e. (3�.� I�� <br />- �l ( 13 0�.v S'�P F�.�n�rr R�2o c <br />I0 ACT FOR PERMR PHa <br />f \ GF-.� � � �il �' �I <br />—CONTRACTOR i R� �� <br />��a., �-� N�T , <br />CONTR. UCENSE � �v�26 ss�-�-O� <br />USE OF BUILDINfi <br />(0-(5 -10 <br />;RMIT N <br />l/�n/o -o�� <br />Ketisu.lpm��' <br />Evcncsr, ��GzA� (4-Z��Z52-a���' <br />HEAT SOURCE I CONTRACT PRICE OF woflR <br />�/� fl� <br />Electdc suas _Other �Cj % ff� — <br />WORKDESCRIPTION CylA4�(�� Qy.r (�� (oL,($ �',,�rt�-'I1C�� A�tj OSA'�1-r'Cb�- h3-��-"CS'Ca t�� <br />tiM3J.� 4Nti) �5 r%��IN� ��OC.''7� L��ue U�`Vp� <br />N0. I TYPE OF FIXTURE Op ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwesher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Greasetrep <br />IRoof dralns <br />Other <br />`:0. <br />TYPE OF FO(TURE OR ITEM <br />A/C - air handlinp units <br />Forced air systems <br />Ges pipinp <br />Waler heater <br />Gas tireplece <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Bolier <br />RetrigerAtion <br />Woodstove <br />i Other <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />I hereby ceritily that I have read and examined this application and know Ihe same to be true and correcl. All provisions ot laws end <br />ordineces governing this type of work will be complied with whether specilied herein or not. The grenting ol a permit does nol presume <br />to give authority to violate or cancel the provision ot any other state or local law reguleting construction or the peAomience ot <br />construction. That I am authorized by the owner ol thls property to pertorm ihe work tor which application is made and I comply wilh the <br />State Contr�ctors Law�:27 RCW and 296200 WAC. <br />