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SITE ADDRESS <br />J �, C) � <br />LEGA LOT N0. <br />DESC. <br />PL.tMIT APPLICATIG_. <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9b�01 <br />425-257-8810 — FAX 425-257-8857 — www everettwa.org <br />0 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />PARCEL TAX I.D. p <br />TRACT OR SUODIVISION p <br />�0G0�'r � /Y1Cm���..C,f :�I _ <br />TENANT NAME � CONTACT FOR PERNIIT <br />3 � f � _ _ — <br />PERMIT p <br />,������ �5/ <br />CITY/ZIP PHONE <br />�.��/ �.�s'-�5�-��:�7 <br />PHONE � <br />CONTR.LICENSEp /T)� ) �)���. �� � �Ci� 1 �) �� �� �f�///� I_' <br />,// !^ <br />USE OF BUILDING <br />� ,> >')i _ <br />WORK DESCRIPTION <br />CUV�f���-i�'i <br />( � ��' ( j <br />� di� < j 0 <br />�O 1��'1 ;�l I <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />l3athtub <br />Lava�ory (wash basin) <br />Shower <br />Ki�chen sink 8 disposal <br />Drshwasher <br />Clolhcs washer <br />Waler heater <br />Sink (service/baihnopletc.) <br />Oack(low preventer <br />Urinal <br />Drinking Pountain <br />Floor drain <br />Giease irap <br />Roof drains <br />Other <br />HEATSOURCE <br />Electric _ Gas � Olher <br />G, (l� <br />,. . _ <br />�/l. <br />iNTRACT PRICE OF WORK <br />�� � !� �� I � �) <br />i- ��� � ��� ,� � r_. <br />, <br />F I � ►��'I�I- <br />MECHANICAL <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced au systems <br />Gas piping <br />Waler heater <br />,1='� Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust lan <br />Hea� pump <br />Unil healer <br />Ooilcr <br />Retrigeration <br />Woodsloee <br />Other <br />CITY Of EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby cerlily Iha� I have read and examined this application and know the same to 6e Uue and correct. All provisions of laws and <br />ordinances goveming this type ol woik wdl be complied wilh whether speciGed herein or nol. The granting ol a permit does not presume <br />I to give authorily to violale or cancel Ihe provision of any o�her stale or local law regulaling cons�ruclion or the periormance of <br />cons�ruclion. Thal I am aulhorized by lhe owner of ihis property t�� perform the work for which application is made and I comply with �he <br />i St::te �ontr2ctors Law 1827 RCW and 2�6200 WAC. � <br />,, , <br />; ��,i� ;,,.� ; �^`�1}�l��rQ� �r �- S ���- �� <br />