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P�RMiT APi�LICATION <br />CITY OF EVERETT PERMIT SERVICE� <br />3200 CEDAR STREET, [VEREIT, 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. # PERM T# <br />���1� �/-�v� � a�78�� a�a»�o � ����iG -2� <br />LEGAL LOTNO. BLOCK TRACT <br />DESC. � lJL7� /_� �� ., �,� _ �._. i �_C_�—, .�. � Yz <br />��� <br />TENANT NAME <br />�--- <br />CONTRACTOR ��N� <br />CONTR. LICENSE # <br />f�r <br />USE OF BUILDING <br />� FeZ <br />� � �P ��L /�.� 1...� . <br />CONTACT FOR PERMIT <br />�Il.�, t-'�1�..1..z <br />WORK DESCRIPTION <br />c������«. <br />NO. <br />PLUMBING <br />TYPE OF FIXTUR[ OR ITEM <br />Toilet <br />�athWb <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Ulher <br />I hereby ceritify <br />ordinacesc�ov <br />to give auth ity to viola <br />Thal I am <br />dors Law 1 <br />Stale <br />����� . <br />PHONE <br />'�c�i�L �T. `��-7' %7�� 2 jC <br />ADDRESS h CITY/ZIP PHONE <br />ipC7EG I � 'Z��Z� S1 LC.�ti[1,�uI�� <br />. �J \ L..JLi f W Jlo <br />HEATSOURCE <br />_ Eleclric � Gas _ Olher <br />CONTRACT PRICE OF WORK <br />�r �� � � l �'l�1�,,1 � � .i'p � <br />7 <br />���.:.� . r " � �, ��- <br />-� ��� <br />���.� <br />NO. <br />MEC <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Foroed air systems <br />Gas piping <br />Water healer <br />Gas (ireplace <br />Gas rangc <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woadstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />read and examined lhis application and know the same to be true and correct. All provisions of laws and <br />e of work will be complied with whelher sper,ified herein or not. The granting of a permit does nol presume <br />i cancel the provision of any other slale or local law regulaling construction or the pedormance of <br />n rized by the owner o( lhis properly to perform the work for which application is made and I comply wilh lhe <br />' RCW and'[96.200 WAC. <br />�la <br />