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SITE ADDRESS <br />' 0 2 l�� <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />TENANT NAME I <br />C NTRACTOR <br />CONTR. LICENSE # <br />USE OF BUILDING <br />l�cRIWIIT �PPLECA.TI�,�I <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />'e �' <br />BLOCK TRACT OR SUBDIVISION # <br />S1�`- <br />WORK DESCRIPTION <br />�`v�va� <br />S� <br />CONTACT FOR PERMIT <br />HEATSOURCE <br />_ [leclric _ Gas _ Other <br />� <br />PERMIT � <br />7 �.nn'� <br />3Go Gsz s'rs/ <br />PHONE <br />CONTKAG I YKI�.c vr nvn�. <br />_ �,� (j 'j �' (,l C W�` �� e l�Gt �.Q _.CS <br />Q <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilcl <br />Dalhlub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sinh & disposal <br />Dishwashcr <br />Clothes washer <br />W ater heater <br />Sink (serviceNar/mop/etc.l <br />Dacl�flow prevenler <br />Urinal <br />Orinkin� Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Other <br />IiC'� <br />TYPE OF FIXTURE OR ITEM <br />AIC — air handling unils <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas tireplace <br />Gas ranc�e <br />Cblhes drycr <br />Range hood <br />Ezhaust fan <br />Heal pump <br />Unit heater <br />Boiler <br />Ro(ric�eration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br />1 hereby cerili(y thal I have read and ezamined this application and know lhe same to be lrue and correct. All provisions ot laws and <br />ordinaces governing this type of work will be complied with whether spocified herein or noL The granting of a permil does not presume <br />to give authoriry lo violale or cancel the provision of any other slate or local law rec�ulaling conslrul'clal on shmade and I comply with the <br />conslruction. Thal I am aulhorized by Ihe owner of Ihis property lo perform lhe work for which app <br />s�:,�n cnntractors Law 18.2yi�W and 296.200 WAC. <br />