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SITE ADDRESS <br />�J <br />LEGALI LOT N0. <br />PERMIT APPLICATION <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 />PARCEL TA% I.D. il <br />Y lJ��,�,� ,� � <br />BLOCK TRACT OR SUBDIVISION it <br />�� <br />PERMIT # <br />I� <br />-c�aa <br />vrvnerc ..��n��� .... „��� . ....�.� <br />�� <br />�� � �- <br />u Lc ���s S,Ft � �,�,�.-�.-�. �vcr y,�'z� � Zs2�s6�� <br />TENANTNAME I CONTACTFORPERMIT PHONE <br />I E�MIAIL <br />z�aF+fi �,4,u .�,,,�;� s� E � � 3 G� 79Y�6' <br />} _o�� � � ,. <br />CONTR. LICENSE M � 1 N 5 1 N-O�� vv� Q� Z 7 Z <br />s-{'A �-Q1Z r 101'$ V-% <br />USE OF BUILDING <br />HEATSOURCE <br />Eleclric Gas Olher <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPT�ON ��r U�.. ��- n�S� �2 �rjlC / ��qr��j - <br />/ � <br />NO, I TYPE OF FIX7URE OR ITEM <br />Toilel <br />13alhtub <br />Lavatory (wasli basin) <br />Shawr,r <br />Kilcher sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Walen c�ater <br />Sink (servicelbadmop/etc.) <br />Backfbw preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grcase trap <br />Roof drains <br />Other <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />AIC - air handling unils <br />Forced air systems <br />Gas piping <br />W alcr heatcr <br />Gas lireplace <br />Gasrange <br />Clolhes dryer <br />Range hoed <br />Exhauslfan <br />Healpump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceriti(y thal I have read and ezamined ihis applicalicn and know the same lo be Irue and correct. All provisions of laws and <br />ordinaces yoverr.in ,th7s type of work will be compli�d wilh whelher specified herein or not The granting ol a permil does nol pr�sume <br />to give aulhority to iolateb � c�el lhe provision ol any olher slate or local law regulating conslruction or lhe performance of <br />conslruction. Th I am aU on: d by Ihe owner of this property to pertorm lhe work for which application is made and I wmply with lhe <br />� <br />Slale CoNraclor ew i W and 296.200 WAC. <br />i ,� ��_ �'�E '�S <br />