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SITE ADDRESS � <br />/� 5 <br />LEGA LOTNO. <br />UESC. <br />OWNEfl <br />mar�r�F <br />TENANT N E <br />N� <br />PERMIT APPLICATION <br />CITY OF EVERETT P�RMIT SERVlCES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereltwa.org <br />APPLICATIONS AHE ACCEPTED FROM 8 AM TO 4 PM <br />�� ��� ' � ����(�1,� <br />- 1 ' <br />� . <br />, . , 2U�9 <br />"VERETT <br />PARCEL TAX I.D. 7J P IT # <br />9bZa3 �9o532a6 3a yo� ��'90z-u�,� <br />BLOCK TFiACTORSUBDIVISIONp <br />l�Vrv I I�qli IVH _ //_ Q� <br />INkS i� i r��� �.() �'' �`"' <br />CONTA. LICENSE p�� i1�M S��g� O� <br />!I <br />USE OF BUILDING <br />W ORK DESCR�PTION <br />FOR PEflMIT <br />�� n� (,�I-c1�5�R- <br />� iz, d��,f� J�� � <br />FHONE �+v t�"J�- <br />�..,.��/�n�fYac� r r �i <br />/�' jjOU - <br />%6'�05 `>76-`65�5� <br />— HEAT �OURCE - I CONTRACT PRICE OF WORK <br />Eleclric _Gas Other �� <br />4�l.anS,C O� l.� )���t-r�G l.ciw�-�� t�.R0.�-22. <br />0 <br />NO. I TYPE OF FlXTURE OR ITEM <br />—f— <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasner <br />Clothes washer <br />Waler healer <br />Sink (service/bar/mop/etc.) <br />�ackllow preventer <br />Urinal <br />Drinking fountain <br />Floor drain <br />Grcasc �rap <br />Rool drains <br />Other <br />NO. I TVPE OF Fl%TUfiE OR ITEM <br />_ NG - air hantlling units <br />Forced air systems <br />Gas piping <br />Wa�er heater <br />Gas lirep�ace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaus�fan <br />Hcat pump <br />Unit healer <br />�oiler <br />Relrigeration <br />Woodstove <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritily Ihat I have read and examined lhis applicalion and know the same lo be true and covect. All provisions o� laws and <br />ordinaces goveming ihis type of work will be complied with whether specified herein or no�. The gianting of a pe�mit does no� presume <br />to qive �uthority m violale or cancel the provision ol any other state or local law regulaling consWction or the pedormance of <br />construction. That I am auUiorized by ihe owner ot Ihis propeAy to pedorm Ihe work for which applicalion is made and I comply with lhe <br />State Contraclors Law 18.27 RCW and 296200 WAC. <br />