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JUI��-�-2C�35 12:45 FF.DM: <br />_=.]4252578H57 P•2 <br />PERMIT APPLICATIC,7N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �_�_ ps <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM - DEBIT & CREDIT CAROS ARE NOT ACCEPTED <br />S�,�A �� Ssy V r ,4�v�� � <br />I ! q�h la <br />LEGA LOTNO. BLOCK TRACT <br />D�nh�. <br />TENANTNAME <br />'�b✓t•� l�c� Ut� <br />CONTRACTOR ADDRESS <br />l,U l� f���t� h�l/c �az�-� �' <br />r� <br />USE OF Bl11LDING <br />,�r-r� <br />LTAXI .# <br />�e x i�n <br />ih <br />FOR' <br />HEATSOURCE <br />_ Electdc X Gas _ Other <br />PERMIT U <br />..:.�;� „ ,, <br />�' 3 s� � <br />PHONE <br />CITV2IP PHONE <br />�j(o 2�d--y`1ao <br />I CONTRACT PRICE OF WORK <br />WORKDESCRIPTION � �4, /_ C��� <br />l��f -�9�I w4 ��� <br />NO. I TYPE OF FIXTIIRE OR ITEM <br />Toilet <br />Bathlub <br />Lavatory (wesh basln) <br />Sho�ver <br />Kilchen sink & dls{wsal <br />Dishwasher <br />Clothos washur <br />Laucdry lray <br />Sink (servicc(barlmuplcic.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Fioor drein <br />Grease trap <br />� Roof draine <br />Other <br />N0. � TVPE OF FIXiURE OR ITEM <br />A/C — air har.dling units <br />Forced air systems <br />Gas piping <br />= Walerhoaler <br />Gas fireptace <br />Gas rango <br />Clothes dryer <br />Rangehood <br />Exhauslfan <br />lieal p�mp <br />Unit heater <br />ooller <br />Re(rigo�2�i0n <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA`: CODE I$ 7705 <br />I horeby cerilify thal I have read and examined Ihis epplication and know the same lo be �rue and wrrect. AIt provisions ot iaws and <br />ordlnaces governing Ihis rype of work wlll be complied w0h whether specKea herein or nol. The granling ol a permit does nol presume <br />l0 9lve authonry lo violate or cancel lhe prnvision oi any other sl�le or Incal law repulaling construcfion nr the pnAortnance ot <br />constructlon. That 1 am authorized by lhe owner ol this properly to pedorm Ihe work lor which ap0licatlon is made and I wmply wilh lhe <br />�!�le Co Iractors La 8 27 RCW and 296.200 W C. � <br />�t��,,,,t �ut F ��lOS C�Zf � �c� 3 <br />, <br />