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l0T IdO. <br />' �Vl� � r�(�s <br />TENANT NAME <br />PERMIT APPLICATION <br />CITY OF �VERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIOtdS ARE ACCEPTED FROM S AM TO 4 PM <br />PARCEL TAX I.D. !I <br />BLOCK I TRACT OR SUBDIVISION # <br />P 8�aq��fh�Ay�.S� <br />CONTACT FOR PERMIT <br />� Ov1u/cCv �/uN�e3' Q <br />conTrcncion�6'/C'Ji9vS�}" f'Q' <br />CONTR. LICENSE # <br />��/em ��/ <br />USE OF BUILDING � <br />�'.�:�pPh�,��. <br />RE55 ) / <br />/O �j B/Uc k 6P/! �Gn. <br />HEATSOURCE <br />,_ Electric _ Gas _ Other <br />PERMIT # <br />�0(1�l -f <br />—' P�n��e 3C0-38/ ?- y� 3.Z <br />E-MAIL p,{qJSTS���/fe <br />�ii�—�AiSN� G-�j y� <br />eF�/anuo�S 4�.2 <br />I CONTRACT PRICE OF WCRK <br />WORKDESCRIPTION�r�y /p// �)�� �,� �j / /,, �+, � /f• u) <br />T �l/ ��� �j� J iJ <br />�.� �•/,�u // l•�'. �f � O�„��P � ,�'3 �X <br />�%.. �- 'F'r ��� NA �i QW C � � <br />NO. I TYPE OF FIXTURE OR ITEM <br />� Toilet <br />Bathtub <br />Lavalory (wash bas' i) <br />Shower <br />� Kilchen sink & disposal <br />_L Dishwasher <br />�[_ Clothes washer <br />Water heater <br />Sink (seivice/bar/mop/etc.) <br />Back(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />� Olher ��� ,CA_ alCCi�07� <br />IJO. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling unils <br />Forced air s�stems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Pange hood <br />Exhaust fan <br />Heat pump <br />Unil heater <br />6oiler <br />Refrigeralion <br />Woodslove <br />� <br />CITY OF EVERETT LO�AL SALES TAX CODE IS 3105 <br />I hereby certify lhat I have read and examined this application and know the seime to be true and correct. All pruvisions of laws and <br />ordinances governiny ihis type of work will be complied with whether specified herein or no�. The granting of a pertnit does not presume <br />to give authority to violate or cancel lhe provision of any other slate or local law regulating consiruction or !he performance of <br />construclion. That I am authorized by the owner of this property lo perform ihe work for which application is made and I comply with the <br />Sta�e Go�itraGt6ls Law 18.27 RCW and 296.200 WAC. <br />