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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-6810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />�,3zo �„J�-TMEaC A.�E , EVtx� <br />LOT NO. I BLOCK <br />DESC. <br />EtJ�u Ct�tUTA1�J <br />TENANT NAME <br />EU2W Ci�CU�AIJJ <br />y�U�l1�T[5'�F�ji �?i1�0EaS <br />CONTR. LICENSE N <br />USE OF BUILDING <br />�,u«t �r�M�,.y �.e5�o� ac F <br />PARCEL TAX I.D. K <br />TRACT OR SUBDIVISION / <br />CONTACT FOR PERMIT <br />�iqr�1C �lAaZ2cN <br />wcp � s 2ac�+ n. P� �eo�.n��� <br />HEAT30URCE <br />,� Electnc _ Gas _ Other <br />WORK DESCRIPTION <br />QFMo+�:.l'N'P�ncr, T�iuT oN I���N Ei..+oA � Rr�,o-.�-/I�i-'P�ncr i�st� ufM.'0. <br />NO. I TYPE OF FI%TURE OR ITEM <br />ioilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Wator heater <br />Sink (service/bar/mop/etc.) <br />BackOow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />PERMI7 iF <br />Xlcr�o - <br />PHONE 20(c,(,:58, }`�S� <br />zs9,a.�'�-. �0 3 S <br />CONTRACT PRICE OF WORK <br />�ztizt, °" <br />N0. I TVPE OF FIXTURE OR ITEM <br />A/C — air hendling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Relrigeration <br />Woodstove <br />Other <br />CIT.� OF EVERETT LOCAL SALES TAX CODE IS 7106 <br />I hereby certify that I have read and examined lhis application and know the same lo be true and correct. All provisions oi laws and <br />ordinances governing this type of work will be c��mplied wilh whether specified herein or not. �fhe granting of a pertnit does not presume <br />to give authority to violate or cancel the provision of any olher stale er local law regulating construction or the perfortnance oi <br />construction. That � am authorized by the owner ot this property to perionn the work forwhich application is made end I comply with the <br />State Comractors Law 7827 RCW and 296.200 WAC. <br />