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SITE ADDRESS <br />-,��� <br />� <br />LEGAL LOT NO. <br />DESC. s <br />TENANTNAM <br />CONTR. LICENSE # <br />USE OF BU <br />PE�KMIT APPLICATIOIv <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 58201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />tJ r�.2e <br />BLOCK <br />b%� n^V' <br />� t,Jn-�.✓ <br />WORK DESCRIPTION <br />C' �l `L� �� g`"� , <br />� l'. <br />TRACT <br />� <br />NO, � TYPE OF f,XTIIRE OR ITEM <br />Toilel <br />�alhlub <br />Lavatory (wash basin) <br />Shawer <br />Kitchen sink 8 disposal <br />Dishwasher <br />�;�lhes washcr <br />Waler heater <br />Sink (servicelbar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />F!oor drain <br />Grease trap <br />Roo( drains <br />Olher <br />PARCEL TAX I.D. # <br />nuuneaa <br />i <br />24;04 �r� <br />CONTACT FOR PERMIT <br />,� ��� � � � <br />ADDRESS <br />H'eATSOURCE <br />Eleclric Gas Olher <br />cirrrziP <br />P MIT# <br />C �.� �/ v <br />�j�'Y� � �aaiC, c,�� <br />PHONE <br />�-L� �4-Z 4-So� <br />PHONE <br />PHONE <br />CONTRACT PRICE OF WORK I <br />�- --- �i�..�.1 � <br />A-cc.�Sci �I�c., ��-i/'an �rc <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air sys�ems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas rangc <br />Clothes dryer <br />Range liood <br />Exhaualfan <br />Heat pump <br />Unil healer <br />�ailer <br />Refrigeration <br />Woodslove <br />O�her <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify lhat I have read and examined this application and know Ihe same lo be lrue and co�recL All provisions of laws and <br />ordinaces governing tl:is type o( �vork will be complied with whether speci(ied her?in or noL Th� granCng o� a permit does ,�ot presume <br />to give aulhonty lo v�olal or cancel Ih provision of any other state or local law regulalinr� �onstruction oi 'he performance ol <br />conslruclion, That I am a thorized by he owner o( lhis property to perlorm the work for which application is made and I comply wilh Ihe <br />Slate Contraclors aw 1 27 R,W id 296.2G0 WAC. — / <br />.7I ��(�' � <br />�/� <br />