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� � <br />P�RMIT APPLICATIGnI <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE DDRESS r <br />' �' Z I�vCiLC �2 ZJ <br />LEGAL LOTNO. BLOCK <br />DESC. <br />OW NER / <br />L.�sc�v <br />TENANT <br />�� 1 <br />t;ONTRACTOR � <br />� �1l + vr�,�5 <br />CONTR. LICENSE # _ <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />TRACT <br />CONTACT FOR PERMIT <br />ADDRESS <br />/Z��,n�7�nz5t,ev«� s <br />35 �9 <br />r I/5/ w�CITY2IP <br />!.,.,.,.. , . , M-�c <br />HEATSOURCE <br />_ Electric � Gas _ Other <br />PERMIT # <br />QY10�( a� <br />PHONE <br />PHONE <br />Z�G-C�3 Z- o'7/D <br />� w� <br />CONTRACT PRICE OF WORK <br />Qp (7 <br />WORK DESCRIPTION <br />�'N5�-1.�� j,�ii-i U2r�Z �rhS f`�-c��2r.luC� �VC�tZU�f,2 � C��gS P� 0/N�, - <br />i iZ .��.75�' II C9`.�S�l� a'f� l�d't-��2 "- . <br />/� �CN f�,� c�N r iv�� , _lZ�-,� � a �� ��5 <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/b��lmop/elc.) <br />Backflow preven-er <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit h�ater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I here6y ceritiy that I have read and ezamined this applica6on and know the same to be true and correct. All provisions of laws and <br />ord�naces governi g this type of work will be complied with whelher specitied herein or not. The granting of a permit does not pres�me <br />to give authority t violate or cancel the provi,ion o( any other slate or local law regulating construction or the peAormance of <br />consiruction. Th I am uthorized by the owner o( this propeKy to perform the work for which application is made and I comply with lhe <br />��ita Cq tracto Law RCW and 296.200 WAC. <br />'rr � .. ��1„�. a.z_�� <br />