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SITE ADDRESS <br />5��'i7 � <br />LEGAL LOT NO. <br />DESC. <br />O�lVNER <br />�i c ra.�a r r� <br />TENANTNAME <br />PERMIT APPLICAT!(�N <br />CITY OF E\/ERETT PERMIT SEFtVICES <br />3200 CEDAR STREET, EVERETT, WA 93201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM i0 4 PM <br />PARCEL TAX I.D. # <br />BLOCK I TRACT OR SUBDIVISION # <br />.�7 <br />PERMI7 <br />' <l�5—S/"l—/Z�j� <br />CONTACT FOR PERMIT PHONE <br />8f%4�� �e�d�=-F L� E MA��J '� `�U y <br />__......._. _.. ..__..--- -.. ._.. <br />�i�"4' d- /JITE /'��rvleG: ItTE. l(;�Gl�( lj�A��.LJ. Lf'�Ni�'c�0 <br />CONTR. LICENSE i! , � �r�.� -7 N z5 -7�5-G�(G �f <br />Df�(�.1—FIt9�i�I %G'� a <br />USE OF BUILDING <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Eleciric �Gas __ Other `'p ,5�0�� �� <br />WORK DESCkIPTION � <br />�PLRCC LJC15TI�JC— �TAS �s/'�a/� CE G(/�Tlf N�� <br />c�il5 J�-L�2r�//I C� �'N v�m�'_ LOCf''RcnJ . <br />NO. I TYPE OF FIXTURE GR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Watcr heatcr <br />Sink (service/barhnop/etc.) <br />Back(low preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease Vap <br />Roo( drains <br />Other <br />tGHANIGAL <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced 2ir systems <br />Gas pipinc� <br />W ater hoater <br />Gas fireplace <br />Gasranne <br />Clothes dryer <br />Range hood <br />Exhaust�an <br />Heat pump <br />Unil healer <br />Boiler <br />Refrigeraliun <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby cerilify thal I have read and examined Ihis applicalion and know lhe same to be true and correcl. All provisions o( laws and <br />ordinaces governing this type of work will be complied wilh whether speci(ied herein or nol. The granling of a permil does not presume <br />lo r�ive aulhority to violale or cancel the provision o( any olher stale or lecal law regulating construction or lhe perfo:mance of <br />construclion. That I am aulhorized by Ihc o�n-ner of lhis property to per(orm lhe work (or which applicalion is made and I comply with the <br />Stale Contraclors Law 18.27 RCW and 296200 WAC. � . <br />� <br />