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PERMIT APPLICATION <br />CITY OF EVERETI' 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 />SITE ADDR[SS <br />Qoa \q��` <br />LEGA LOT N0. BLOCK <br />OESC. <br />OWNER <br />r�cu�. 1�11y g <br />TENANTNAMB <br />o Ta ; i,n,v`a� _-1 <br />CONTR. UCENSE A �C ��,\ _ _ <br />Y\« <br />USE OF BUILDING <br />PARCEI TAX I.D. # <br />J_�i–o 0 7. <br />TRACT OR SUBOIVISION A � <br />I\C-ONTACT FOR PER(�M��T <br />�1U (YV t C�J CJ r�YLIV..(1 <br />AD S �{ lp i i J �� P` <br />.. <br />PHONE <br />�o --��--r3 <br />PERMIT f! <br />n I � I (;_ D�0 <br />��I•L �,0� ��1 � � OC} c•.c �� <br />�j F;11� E. � <br />— HEAT SOURGE I CONTRACT PRIGE OF wc�nn <br />✓ Electric _ Gas _ Other � ��O <br />WORK D[SCRIPTION 1 � �U � <br />� �l ��a-\1 � c.���e S 3 i_j�.v� <br />NO, I T'FE OF Pt%TURE OR ITEM <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />NitChen sink 8 disposal <br />Dishwusher <br />Clolhes NJshet <br />Watni healer <br />S�nk (Servlcebar/mapletc.) <br />BaCkHow provCnter <br />Urinal <br />D�inking Foun4vn <br />Floor drain <br />Greasc trop <br />Rool drnins <br />I Othcr <br />NO. I 1YPE OF FIXTURE OR I7ER7 <br />A/C – �ir h�ndling unit5 <br />Forced av systems <br />Gas p!p��g <br />Water heater <br />Ges fireplace <br />Gas range <br />Clothes dryer <br />A,�nqe hood <br />Exhausl lan <br />Hcat pump <br />Unit henter <br />Boiler <br />Relriyeration <br />Wood,lova_ <br />CI7Y OF LYERETT �OCAL SALES 7aX CODE IS 1t05 <br />I hereby cediy that I have read a�d examined Ihis apDlication and know the same to be true and cm�ecL All provisions of laws arW <br />ordinancxs governinq inis type of work wll be complied with wheth�r speGfied herein or not. The grantinp of a pe�md does not presume <br />to give aulhonty lo holate or qncel MC provision of ony ottwr state or local l3w fec�ulaling consiruclion or the performance of <br />consl ction. That I am euthonr d by �he owner oi Ihic property to pertorm Uic work ior which applicatlon IS made and I comply v+ith Ihe <br />${atc ontracta�s Law 18.27 �nd 2 8.�200 W��. , ola�l �3 <br />r -� <br />n. .� ,, n � . /J � – <br />