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PtRMIT 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 />SITE ADDRESS <br />33�G <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />D�+v�u Lf� LoniOE <br />TENANTNAME <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br />BLOCK <br />PARCEL TAX I.D. # <br />U�k3G979� <br />TRACT OR SUBDIVISION # <br />33� �ccKEFEu6L /�iv�e, <br />CONTACT FOR nPERMIT <br />i�►�=4'A�*� KphDC1.�Ff <br />ra / <br />0 -J ' � <br />` :�Yo--N23 -5dlo <br />PHONE <br />,5. 795 --(o yG �% <br />GONTRAGIUK NVURGJJ ,��� ••.�^•. <br />Df+Y �-�iT� !'lr,�.. �- l�� ���,�y �3�i( ,4�►�t.l,c,) - L y���'"`�''��/ `''` <br />CONTR.UCENSEp���pHoyy��� ��z'7 "7�'"��S�I�G`/ <br />✓ <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />_ Eleclric � Gas _ Olher jf' �j �'�'� <br />WORK DESCRIPTION <br />,�",�s,—�� �r/e� ftEar Pcsm�o, <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />�athlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Waler healer <br />Sink (service/badmop/elc.) <br />Backflow prevenler <br />Urinal <br />Drinkiny Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Olhcr <br />NO. I TYPE OF FIXTURE OR �TEM <br />NC — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas tireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigerelion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceritify tl�at I have read and examined this applicalion and know the same to be true and correcL All provisions ot laws and <br />ordinaces goveming this type o( work will be complied with whelher specified herein or not The granling of a permit does not presumo <br />to give aulhority to violate or c2ncel lhe provision of any other slale or �ocal law regulaling construc;ion or lhe performance oi <br />construction. Thal I am authorized by lhe owier o( lhis property to peAorm the work for which application is made and I comply with the <br />R�air.Fnnlrar.lnrs LawAAlL7 RCW ad�r2tJfi.200 WAC. <br />