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SITE ADDRESS <br />LOT NO. <br />DESC. <br />� <br />P�RMIT 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 />BLOCK I TRACT <br />PARCEL TAX I,D. # <br />.�d'/tGt.�LE rie_�G2CK �Z � 5���••-.-��� -.-- <br />TENANT NAME CONiACT FOR PERMIT IPHONE <br />I �� ti Z�'(.� � 73 a 3a-� <br />CONTRACTOR �j��j �/� L/,ci1� ADDRESS,�$a.(� �c.�ryx �.,r CITY2IP PHONE <br />��*!i< �g ve,.t�. $.P.� 63e2 -0 8n� <br />CONTR.LICENSEp ��� f U u ���,v �T I,�- I�`V� ��� <br />USE OF BUILDING <br />�l�t C� ✓�Li2r.�i �j ✓�i f, <br />DESCRIPTION <br />�{� �i?a c <br />� %%d1 ��'``/ <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilcl <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchon sink 8 disposal <br />Dishwashor <br />Clolhes washer <br />Water haaler <br />Sink (service/badmop/elc.) <br />Back(low proventer <br />Urinal <br />Drinking Fountain <br />Flonr drain <br />Greasetrap <br />Roa( drains <br />Olher <br />HEATSOURCE <br />_ Eloclric _ Gas _ Olher <br />�J/JC� /�llt <br />/ ���� <br />CONTRACT PRICE OF WORK <br />.3/, .'�� <br />Zdt/r� �/l.t.-...i — s <br />Gf�'y-' �'� ` c /' �it..� %� <br />NO, � iYPE OF FIX7URE OR ITEM <br />wc – air nanaiing units <br />Forced afr systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrango <br />Ciolhes dryor <br />Range hood <br />Exhauslfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeratlon <br />Woadstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I heroby ceriti(y that I havo read and examined this appiication and know the same to be true and correct. All provislons of laws and <br />ordinaces governing lhis lypo of work will be complied wilh whether specified heroin or not. The granting of a pertnil does not presume <br />to give authority to violate or cancel the provision of any othor state or Iocal law regulatlng constructlon or the performance of <br />conslruction. That 1 am authorized by tho owner of lhis proporty to perform the vrork for which applicaUon is made and I comply with lhe <br />State Co,nt�ract s Law 18.27 RCW and 296200 WAC. <br />�5.�- �� /.�/.,� 2�� ��� � <br />