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SITE ADDRESS <br />73od CJe <br />LEGAL LOT NO. <br />OESC. <br />TENANTNAME <br />CONTRACTOR <br />CONTR. LICENSE M <br />USE OF BUILDING <br />(�.��e.�/� � oa/ <br />WORK DESCRI�TION <br />��- ��o� <br />PtkMIT APPLICATI�.+N <br />CITY OF EVERETT PERMIT SERVICES �� _ a s- o(� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org 6� b� O-Ob v <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� PARCEL TAX I.D. M <br />BLOCK TRACT <br />ADDRESS <br />� % �O a ��Qt-(.�,cV� �V'e <br />� CONTACT FOR P RMIT <br />� 131v� e� � <br />ADDRESS ��� <br />NEATSOURCE <br />� Electric _ Gas _ Other <br />�,,�r/�� <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilel <br />Dathtub <br />Lavalury (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mopletc.) <br />E3ackflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grea�e irap <br />Roo( drains <br />Olher <br />P RMIT q <br />S(�io-c..v <br />,�,.-. .. �r , �..-.... . � .���.. <br />PHONE <br />� �s- 359� oo y�/ <br />CITY2IP PHONE <br />I CUNTRACT PRICE OF WORK <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify Ihal 1 have read and examined this application and know the same to be true and correcL All provisions of laws and <br />ordinaces �overning Ihis type of work will be complied �. iith whelher specified herein or not. The granting oi a permit does not presume <br />to give authority to violate or cancel the provision of any olher state or local law regulating consWction or the pedormance ot <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and i comply with the <br />Slate Coi1tractors Law�A27 RCW and 296.200 WAC. <br />!dU"tiL% "`i�LWVU/V I ll( �7/A-(iQb <br />