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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-2�7-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS n� �,� <br />�� � � �,� �i9l�� <br />LEGAL LOTNO.TI BLOCK <br />DESC. 7 I <br />PARCEL TN( I.O. # <br />o s�73 i o00o yre o <br />:%�' <br />TRACT OR SUBDIVISION p <br />Of S�'�'O"�% PGA?7" /�02—OZ`�—o L <br />ADDRESS CITYIIIP PHONE <br />� <br />_�c'►� G Ne�u,�Q�n zs ii3 fi c�:. NZs-3s.�-1 Ja/ <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />�� _ ����%i E•MAIL/JCw/4n1i �1/E'Li� <br />CONTR. LICENSE M <br />Q[+%�f%�� <br />USE OF BUILDING <br />11(���-.CidG-�G�� <br />WORK DESCRIPTION <br />1,;;. <br />P_UMBING <br />NO. I TYf't OF FIXTURE OR ITEM <br />� foilcl <br />_� f3athlub <br />Lavalory (wash basin) <br />�_ Showor <br />� Kilr,hen sink 8 dispo .:il <br />1 DISI1W85�1Cf <br />_f_ Cloth�s w�shr,r <br />Walr.r hr,alcr <br />.�_ Sink (servicr,lbarlmop/elc.) <br />Dackflow prevonlor <br />Urinal <br />Drinkinp Founl�in <br />Floor drain <br />Grnasa�rap <br />�_ Roul drains <br />Other <br />HEATSOURCE <br />_ E-loc�ric .� Gas __ Olher <br />/ � � �1 <br />�,_� r .;��/ <br />N0. I <br />CONTRACT PR�CE OF WORK <br />TYPE OF FI%TURE OR ITEM <br />A/C – air handling unils <br />Forced eir systems <br />Gas pipin� <br />Watet hoaler <br />Gas fireplace <br />Gas ran�� <br />Clalhes dryer <br />R2ngo hood <br />6xhaust fan <br />Heatpump <br />Unil hea�er <br />�oiler <br />Rofrigeralion <br />Woodslove <br />Olher _ <br />CITY OF EVERETT LOCAL SALES TAX COOE IS ]105 <br />I hr.reby cenhfy �hat I havo read and aaamined lhis applica�ion and Know Ihe same to be Irue and correcl. All provisions ol I�ws and <br />ordinacr.s yovernin� Ihis type of work will be complied with whether specilied herein or not. The �ranting uf a permil does nol presume <br />lu give aulhority �o violato or cancel Ihe provision o� any olher s�ato or bcal law rogulaling conslruclion or Ihe perlormance of <br />conslruchon lhal I am aulhoriz<�d by lhe owner of Ihis property lo perform lhe work lor which apphcalion Is made and I comply witii lhe <br />State C � c ors Law 18.7JeRCW and 29�.200_WAC. <br />��z <br />