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SITE ADDRESS <br />3tz� wE�� <br />LEGA LOT NO. <br />DESC. <br />OWNER <br />�+ii l l G <br />TENANTNAME <br />CONTRACTOR <br />CONTR. LICENSE It <br />USE OF BUILDING <br />�RMIT APPLICATIC�N <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 <br />A� Z <br />BLOCK <br />PARCEL TAX I.D. # <br />0'-1 3 °I �'1 l. G � <br />TRACT <br />2ZbS-i1O�i�•. LrJ S.f. SAw.wn`►n�S1{.wA <br />ICONTACTFORPERMIT PHONE <br />21�Y 10EAS C <br />L�id%%l��- ( -� <br />fa P n aT �,.. �t r1 .— <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />WORK DESCRIPTION <br />• RtmoJ �tr 2.CPl,Ac6. R.6oF� <br />-Ra,.`.oJtrR1P�A�+L to�+ILR- OVTS�OL �PIGONIh.J <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Watcr healer <br />Sink (serviceNar/mop/etc.) <br />Backtlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />Cqzs�Z31- �� go <br />CITY2IP PHONE <br />GON1FiAG1 YKu:e�rnvrtn <br />3 Q, y 4q <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air syslems <br />Gas piping <br />Waler heater <br />Gas tireplace <br />Gas rango <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Re(rigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />1 hereby ceritify that I have read and examined lhis application and know ihe same lo be hue and wRecL AI� provisions of laws and <br />ordinaces governing this type of work will be complied with whether specitied herein or not. The granting of a permit does nol presume <br />to gi�e autho�ity to violale or cancel lha provision of any other state or local law rogulating construction or the peAornance of <br />cons:ruction. That I am authorized by the owner of this property fo perform the work tor which application is made and I comply with lhe <br />State Conlractors Law 18.27 RCW and 296200 WAC. � <br />I Z IL <br />� <br />g4S.r9 <br />