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SITE ADDRESS <br />�/ t n �n'i� <br />LOT NO. <br />Z <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SER!/ICES <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 />PARCEL TAX I.D. X <br />BLOCK I TRACT OR SUBDIVISION • <br />AAr CaM�n�nica��ons <br />TENANTNAME <br />CI¢ArW irG <br />CONTR. LICENSE N <br />USE OF BUILDING <br />Cnm�,u��ca�ton ko�wpo(e <br />WORK DESCRIPTION � ( I <br />rn.�uowavt dcel, avHtPt-23, <br />NO. , TYPE OF FU(TURE OR ITEM <br />Toilet <br />� Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer � <br />Wa:er heater' <br />Sink (service�bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />CONTACT FOR PERMIT <br />Mtchae( Cdc <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />���/� <br />IT # <br />'D -037 <br />PHONE ,c�Zs- '7��£" o9q9 <br />E•MAIL <br />CONTRACT PRICE OF WORK <br />� 7,voa <br />ih �gq0 100bt �{+tfpntea +o SecYarG 240'� R�P(Q� � <br />Add i �lvdwei RRU 37�2. <br />� <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handlin� units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rar�ge hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Relrigeration <br />Woodsrove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined ihis application and know lhe same to be true and correct. All provisions of laws and <br />ordinaces governing ihis �ype of work will be complied wi�h whether specilied herein or not. The grenting o! a permit does not presume <br />to give authority t� violate or cancel the provision of any other state or Iocal iaw ragulating construction or the performance of <br />con�truct�an.'fhat I a�u�horized by the owner ol ihis property to perform the work for which application is made and I comply with Ihe <br />State�Coniiacta�s Lav� 18�$j�RCW and 296.200 WAC. <br />�J <br />CC�M <br />