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P'�RMIT APPLICATI(��� <br />CITY OF EVERETT PERMIT SERVI�CES <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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />s� i� 1�����,nil ; t x/ /����' <br />LEGA LOT NO. BLOCK <br />DESC. <br />✓.L i C'n.� <br />TENANT <br />PARCEL TA7( I.D. # <br />TRACT <br />j L'/�% �(�jLi�9�Nlii�nJi�'L� <br />CONTACT FOR PERMI7 <br />� I L� Cci.dC-f2 <br />��- <br />CONT/R�ACTOR , /• ADDRE.`.5 <br />/�iG C.�c�cl�/ Con..s.tilt; iiL.S <br />CONTR. LICENSE p <br />USE OF BUILDING HEAT SOURCE <br />_ Electric �Gas _ Other <br />WORKDESCRIPTION � � R r ��� i>rCT�X- <br />�/.v ///lS A�C.:-S <br />�,5�,��� oz l,�j /:,ee'� <br />N0. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchu� sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry traY <br />Sink (servicelb2r/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />CITYRIP <br />PERMIT # <br />m dy < <-oz� <br />. .._..�.�75� � <br />Ti ��7 C/5 U <br />PHONE <br />PHONE <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced sir systems <br />Gas pipin� <br />Water heater <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SAIES SAX CODE IS 7105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. AII provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority lo violate or cancel the provision of any other state or local law regulating construj ca� °� shmade a dal comply with the <br />�,,..�r���f��n. That I am authorized by the owner ot this property to perform the work for which app' <br />