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PERMIT APPLICATIOrI <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 />SITE AUORESS <br />1 � n � <br />LEGAL LOT NO. <br />DESC. <br />r�ri�r <br />TENANTNAME <br />PARCEL 7AX' o. # <br />BLOCK I TRACT OR SUBDIVISION N <br />-- a s -09 <br />IIT p <br />AODRESS CINIZIP PHONE <br />�>�5 - � � 3 -�v 9 <br />7CD� CG'r7:�>,-�,�- ���cs..r�.�u� <br />CONTACT FOR PERMIT <br />corvirencivn � ���n��� <br />�/ ��.� /�tv^ ,7<•r�� 5 � �'Y v-<.-c._ -�L�- <br />CONj42. LICENSE A ��L' � � Lti ✓l/�c-L-. <br />Ef "/_���t'SS�yz kL <br />USE OF BUILDING HEAT SOURCE <br />� P 5 _ [lectric � Gas _ Olher <br />i ' <br />WORK DESCRIPTION <br />��i 4 � �C J�' �Gji-i74 �-- e— <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Balhlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washcr <br />W aler healer <br />Sink (service/badmop/etc.) <br />BackOow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease Inp <br />Roo( drains <br />Olhcr <br />NO. <br />PMONE <br />C -C{v� <br />T6z�/ <br />/�2 ) � <br />��� —�_ <br />—�. J <br />)NTRACT PRICEO F WORK <br />3//D� <br />TYPE OF FIXTURE OR ITEM <br />NC - air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas lireplace <br />Gas r2nge <br />Clolhes drycr <br />Ran�e hood <br />Exhausllan <br />Neatpump <br />Unil healer <br />Boiler <br />Refrigcration <br />Woodslove <br />CIN OF EVERETT LOCAL SALES TA% COUE IS 3105 <br />I hereby cerilify that I have read and examined lhis applica�ion and know lhe same W be true and correct. All urovisions of laws and <br />ordinaces �oveminc� lhis type ol work will be complied with whelher specilied herein nr nol. The granling ol a permit does nol presume <br />�o yive authority lo viola�e or cancel Ihe provision of any olher state or local law regulating consWction or lhe pertormance o( <br />conslrucliun. Thal I am authorized by the owner of this property to peAorm the work (or which application is made and I comply wilh Ihe <br />Slale Conlraclors Law.18.27 'and 296.200 WAC. <br />�/./ % �- � �' %'Z� —U9 <br />