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� <br />������ 1����1C�1�1�'� <br />ClTY OF EVEF;ETT PERMIT SERVICES <br />3200 CEDAR STREE"f, 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 ADDRESS PARCEL TAX I.D. # <br />9r�r 9J�.�',•� SEc��.��,/�� �Yzv Gb663�-ODO-O/l�oo <br />LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION # ,l <br />DESC. // /�✓1C•�f�/7C'%�YJf/✓ �/YiJ/d/1 �7 <br />r�d /�/. 7�s✓/�'- %%/� c�� �✓t S� �[/C/'�� �J/P <br />TENANTNAME <br />s,-,� <br />CONTR. LICENSE # <br />USE OF /BUILDING <br />�i�� /t .r�✓.,' l,� <br />WORK DESCRIP"fION <br />CONTACT FOR PERMIT <br />�f/ yzr z�s �L6s�,� <br />q�_ �g�ll <br />PErZMIT # <br />,�j�ii/ -029 <br />PHONE <br />7�"Z �'�'' yLT v3' .1 <br />I'FIVNt � <br />'J/�A/l'914t ��u.nt <br />HEAT SOURCE I CONTRACT PRICE OF WORf< <br />F/p,M � I � Electric _ Gas _ Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shawer <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heaier <br />Sink (service/bar/mop/etc.) <br />f3ackflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease Irap <br />RooF drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heafer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausl fan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi(y Ihal I have read and examined ihis applicalion and knovi the same lo be Irue and correcL All provisions of laws and <br />oidineinces governing ihis type of �vork will be complied v�ith whelher specified herein or noL The granling of a permit does not presume <br />to yive authoriry lo violate or r.ancel the provision of any other state or local law regulaling conslruclion or lhe performance of <br />consiruction. Thal I am authorized by ihe owner of this property lo per(onn the vaork tor vahich applicaiion is made and i comply wilh the <br />Slate Contractors Law 18.27 RCW and 29�C200 WAC. <br />i �' <br />