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SITE ADpRESS <br />�� ^ ��A= <br />LEGA� LOT N0. <br />�FSC <br />ll <br />TENANtN►ME <br />CONTR. LICENSE C <br />USE OF BUtL�ING <br />PERMIT APPLICATION <br />CITY OF EVERETT PE�CMIT SERVICES <br />3200 CEDAR STR[ET, EVFRETT, WA 98201 <br />425-257•8810 — FAX 425-257•8857 — wvrN.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />PARCEL TAX I.D. A <br />BLpCK I �ACT OR SUB�IVISION 7t <br />l CONTACT FOR VERMIT <br />-rlv..� �.1 Z � LJ �/i�.�l <br />ADDRESS l{ lp i � j � <br />PL <br />HEA7SOURCE <br />�ctrc _,Gas_O:her <br />WORK DESCRIPTION <br />� fl SJAI� � C�-�.e S J �-� '�v � <br />PIUMBING <br />NO. I TYVE OF FIXTUFE OR IIEM <br />_� TOilel <br />' Bathtub <br />Lavalory (wash basin) <br />' ShowF;r <br />Kitchen 5ink 8 diSDosal <br />� pi5hwa5h¢f <br />� Clothe, wnsher <br />' Water heater <br />Sink (,ernce/batlmapletC.j <br />Batkflaw preventer <br />� Unnai <br />prinking Pounlain <br />FIOor tlram <br />—� GrEaSC il2p <br />� R001 drams <br />Olher <br />PHONE <br />�j���6 <br />PERMIT M <br />m13o8- bzl <br />p0 <br />�n� ��1 � �� cc} �•.�; <br />CONTRACT PRICEOF WORK <br />3, �co <br />N0. � TYPE OF F'IXTURE OR ITEM <br />NG –:fir h�ndling urr,ts <br />Forced au systems <br />Gas piping <br />� Water heater <br />� Gas fireplece <br />Cos range <br />_ ClMhns dryer <br />Rnngn hood <br />^ Exhausifan <br />� Healpump <br />� Unit heater <br />_ �oiler <br />Retrigeration <br />_ Wood510Ve <br />C�TY OF EVERETT LOCAL SALES TAJf CODE IS 7t05 <br />I hereby certiy inat I have read and examined tbis application and know the s2me to be true and wrt2ct. AII provisions ol i;ws and <br />ordinances qoverning this ype of worR will be complied witn whether speCified herein or not The granting of a pertnit does rol D�esume <br />to give authority to v�olate or cancel �he provision of any offier state or iocal law regula6ng construcnon or the pertormunce ol <br />constr ction. 'That I am auihoriz d by the owner o� Ihis property to pertorm tne work tor which opplicatlon is made anG I comply v�rth the <br />Stete ontractors Law 18.27 and 2.�AC <br />? R� I� � 1`3 <br />