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SITE ADDRESS <br />LOT NO. <br />DESI: <br />P�r2MIT APPLICATIO��I <br />CITY OF EVERETT PERMIT SERVICE� <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 1 PM <br />PARCEL TA% I.D. p <br />BLOCK I TRACT OR SUBDIVISION M <br />3��2 <br />PERMIT K <br />�I DQ3- 005 <br />�f%�j%�' / �OL./.U/-�- vr� I C) JI%NJr� CN • GGL�1('l� ' 7�J �.C�J ('YZlr�i7JJ -V v S d. <br />TENANT NAME � I CONTACT FOR PERMIT PHONE <br /><K9• �. .��. .�� <br />CONTR, LICENSE It <br />USE OF BUILDING <br />WORK DE�CRIPTION <br />:5'�/1�OVQI Uf f�/,t'Y' /b�17 . <br />N0. I TYPE OF FIXTIirZE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kdchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (seivice/badmopletc J <br />BackOow pmventer <br />Urinal <br />Drinhing Fountain <br />Floo� diain <br />Grease trap <br />Roo( drains <br />Other <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />[lectric Gas Other <br />C[�7 <br />7YPE OF FIXTURE OR ITEN. <br />AIC — air hanaiing units <br />Forced air systems <br />Gas piping <br />Water hea�er <br />Gas firepl•�ce <br />Gas range <br />Clothes dmer <br />Range hooa <br />Ezhaustfan <br />lieat pump <br />Uni� heater <br />Boiler <br />Refriyeration <br />Woods�ove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby certity �hat I have �ead and examined ihis application and know the same to be irue and wrrect. All provision5 0! laws and <br />ordinances governing Ihis lype ol work will be comp6ed with whether specified herein or not. The granting of a permit does no� Dresume <br />lo give authority to viola�e or cancel Ihe provision of any olher state or Iocal law regulating consiruction or the peAormance of <br />construclion. That I am authorized by the owner ol ihis property to per(orm ihe work for wMch application is made and I comply with ihe <br />Stale Conlraclors Laei 1827 RC1M1' and 296200 WAC. <br />s%; <br />� <br />ll <br />�i��,^__ <br />