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pERMIT APPLICATIUN <br />CITY OF EVERE7T PERMIT SERVICES <br />3200 CEDAR STREET, EVEREfT, WA 98201 <br />4?_5-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />9ESS � -� PARCEL TAX I.D. # <br />� � <br />�Cl.l���:ir� t-II�L, C:l?`h�`�pCL)� �Lp <br />LOTNO. ELOCK iRACTORSUBUIVI510Np <br />j)1'�'i�:� ��l�L'�/, <br />TENANTNAME <br />, <br />'�,-, z G�� <br />� �= H4��� r�����,��+ ���'��:'� <br />FOR PERMR PHONE <br />�„�va�s J, � �-�-. �, � ��w/ � � n� . <br />� � Ct' ' Q' �5 �DO�Ii I[i7Rr tl�c� i� l�' <br />CONiA.LICENs�n��H��9sa �.�7 <br />J�az/le� ux , (,�1a %B�'U S <br />USE OF BUILDING <br />( �, <br />7�v `, IiL` �'�`C.l-. <br />WORK DESCRIPTION <br />HEATSOURCE <br />Electric �Gas_Other <br />d��J`'� % <br />PERMIT # <br />�10�tD'� -u3a <br />HONE <br />�11.% ; 7'i -tii <l <br />��v�<<� yw�e� <br />�oo - <br />9�g-�s� � <br />CONTflACT PRICE OF WORK <br />7Y4 ' <br />� ; <br />� <br />� <br />�;� .— � �i�l� nn i <br />�f I �� .,t d ��i � �.��_ �.V��,��� -�.i.�r��� <br />I' <br />NO. I 7YPE OF FlXTUHE OR ITEM <br />Toiiel <br />Dathtub <br />L�vatory (wash bacin) <br />Shawer <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water healer <br />Sink (servicelbar/mopletc.) <br />Backllow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasc irap <br />Roof drains <br />Olher <br />NO. <br />TYPE OF Fl7(TURE OR ITEM <br />NG — air hantlling uni�s <br />Farced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangchood <br />Exhaus�fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />CIN OF EVERETT LOCOL SALES TAX CODE IS 3105 <br />I hereby ceritily thal I have read and examined Ihis appliraUon and know the sarne to be true and correcl. Ail provisions of laws and <br />ordinaces govemin� Ihis type of work wili be compiied with whether specified herein ur noL The graming of a pertnit does not presume <br />�o give au�horiry to violale or cancel �he pmvision ol any other state or Iocai law repula�ing consiruction or the pertormance ot <br />constmclion. Tlmt 1 am aulhorized by �he owner ot �his property �o pedorm the worie lor which application is made and I comply wilh the <br />State Cnntrar.lrns L�w 18.7.7 RCW and 296200 WAC. <br />