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SITE ADDRESS <br />LOT N0. <br />TENANT <br />( <br />PERMIT APPLICATION <br />CITY OF EVERETT 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 />PARCEL TAX I.D. M <br />S� �Q S.� � <br />BLOCK TRACT ON SUBDIVISION N <br />7/5 <br />Ev,p��i <br />,tG[ ST 5 E <br />FOR PERMIT <br />/1f,-ocu� <br />PERMIT N <br />u`' � — <br />10NE <br />5-35.� c <br />PHONE <br />� 7�s-� �� y <br />VVn1I�I�Y1Vn ^ •• <br />jaq�y d- n/ rr� �Crr/scr: � HTC • 1(�G l�l ! 3.� Aw• ll!- �Y,J,� .��5, 775-6�1G�%' <br />CONTH. LICENSE N,��N� �pH 9� f�n � ��Q 3� <br />l�CY <br />USE OF BUILDING <br />MEATSOUHCE <br />Electric _ Gas _ Olher <br />WOHK DESCRIPTION �' <br />/NS'iAtL /� /✓�� OZ4CT LESS <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water healer <br />Sink (sernce;barmopietc.) <br />Backflow prevenler <br />Urinal <br />Drinkmg Fountain <br />Floor diain <br />Grease irap <br />Rool drams <br />Other <br />CONTRACT PRICE OF WORK <br />,� � �� � <br />K�T P��.n� -SY.� , <br />N0. I TYPE OF FIXTURE OR ITEM <br />A-'C — air hanlling uni�s <br />Forced air systems <br />Gas piping <br />Weler hBater <br />Gas Itreplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />EKhaustlan <br />Hent pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 7105 <br />I hereby ceritBy that I have read and examined this apphcalion and know the same to be true and correct. All provisions ol laws and <br />ordmaces governing ihis type of work will be complied vnth whether specdied herein or no�. The granting o� a permA dees not presume <br />to gwe authorily to violate or cancel Ihe provis�on ol any other state or local law regulating consWction or the performance of <br />construcl�on. That I am aulhonzed by Ihe owne� of Ihis pmperty to perform the work lor which applicatlon is made and I comply wilh the <br />State CoNractors Law 18,27 RCW aye}Q96 200 WAC. / � <br />