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F�RMIT APPLICA <br />CITY OF EVERETT PERMIT SERVICFS <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8a57 — www.everettwa.org <br />APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />BLOCK <br />DESC <br />r <br />PARCEL TAX I.D. p <br />�c�y-� � i cv a cx� 2d�c� <br />TRACT OR SUB�IVISION p <br />� � .. a S`-o�i <br />PERMIT # <br />SG�1i/ - oa <br />� I���; I�( c I� L' �7 2�3 Z Eirru� A"�- �ve.r� <br />TENANT NAME � CONTACT FOR PERMIT PHONE 3(p�• (0'71 - I'3 3 <br />T►'� S�tj �� <br />E-MAIL <br />.....,..___ — _ <br />Zo��fE'.ga✓.a�v:cw2cr ���;�Sn��m 3�o-c��i-13�Ij <br />CONTR. LICENSE il �fr�4 <br />51C11J�'I �hlosmm <br />USE OF BUILDING I HEAT SOURCE � CONTRACT PRICE OF WORK <br />_ Etectric _ Gas _ Olher <br />1hS-�eei_.�CJ� C�-r�� t�.-'r`��sp��� s��n <br />PLUMBING <br />NO. I TYPE Of FIXTI:RE OR ITEM <br />Toilet <br />Balhtub <br />Lavalory (wash basin) <br />Sh�wer <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler healer <br />Sink (service/badmop/etc.) <br />�ack(low prevr.nler <br />Urinal <br />Drinkin� Founlain <br />Floor drain <br />Grease Vap <br />Roo( drams <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Forced air systems <br />Ges piping <br />Water heater <br />Gas tireplace <br />Gas ranc�e <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit healer <br />Boiler <br />Reirigeralion <br />Woodstove <br />CITY OF FVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceriti(y that I have read and examined Ihis application and know lhe same to be true and correcL All previsions o( laws and <br />ordinaces �overninc� this type of work will be complied �vilh whether specified herein or noL The granling of a permil does not presume <br />Io c�ive authoiity lo violate or cancel th� provision ol any other state or local law regulaling consWctior. �r the performance of <br />co�truction. That I am authorized by lhe owner o( Ihis property lo perlurm the work for which application is made and I comply wilh lhe <br />Sta �e Co}' ctors La� � tfl.27 RCW and 29 200 WAC. // /� <br />/ \V � . �,�'o /J , . � � C1 <br />,'Z <br />