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SIT--E7 ADDRESS <br />LEG LOT NOI <br />DESC. <br />OWNER <br />TENANT E � <br />I��RMIT APPLICATIVN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. k <br />BLOCK I TRACT <br />3y�S l`j2"°� St (V� ;'��. <br />CONTACT FOR PERMIT <br />PERMIT / <br />R82z- <br />�/atcu�n�%' � 'zv6-235- l01-1 <br />CONTRACTOR ��� ADDRESS CIT'21P PHONE <br />CONTR. LICENSE N <br />USE OF BUILDING <br />�;�,;�I <br />WORK DESCRIPTION <br />��� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Ki�chen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heator <br />Sink (service/bar/mop/etc.) <br />Backliow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Greaso trap <br />Roof drains <br />Olher __ <br />HEATSOURCE <br />�Eleclric _ Gas _ Olher <br />� <br />CONTRACT PRICE OF WORK <br />�-5soo <br />TYPE OF FU(TURE OR �TEM <br />A/C — air handling units <br />Farced air systems <br />Gas piping <br />Water heater <br />Gas fircplace <br />Gas rang; <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. AII provisions o( laws and <br />ordinaces governing this lype of work will be complied with whelher specified nerein or noL The granting of a pertnil does not presume <br />to give authority to violale or cancel lhe provision ot any other state or local law regulaling conslruclion or lhe peAormance of <br />conslruction. Thal I am authorized by the owner o( this property to perform the work for which application is made and I comply with the <br />Slate Coppr�lors Law 18.27 RCW and 2�J6200 WAC. J , <br />. .._ _....._._—r' <br />i � <br />