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SITE ADDRESS <br />�-//3flJ � <br />LEGAL LOT NU. <br />TENANTNAME <br />CONTRACTOR <br />/ <br />CONTR. LICENSE M <br />USE OF BUILDING <br />FcRMIT APPLICATIIaN <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 �CEPTEn FROM 8 AM TO 4 PM <br />I PARCEL TAIC I.D. p <br />�L <br />BLOCK <br />� <br />(',(c�i�(�/� <br />WONK DESCRIPTION <br />,� <br />�;.1� t1,,.,)<- ►�c'.yY�t�l <br />0 <br />NO. I TYPE OF FIXTURE OR i7FM <br />I ToIILI <br />I Balhlub <br />Lovatory (wash basin) <br />Showei <br />Kilchen sink 8 dis�>osal <br />Giehwasher <br />Clnlhes washcr <br />Watcr henlr.r <br />Smk (servicclbadmop/cic.) <br />Backllow preveNer <br />Urinal <br />Drir�kinc� Poun�ain <br />Floor dr;un <br />Greasr.irap <br />Rool dnins <br />Olher <br />TRACT <br />S�- //�Llv a�r:�et S.f� <br />CONiACTFORPERMIT <br />ADDRESS <br />HEATSOURCE <br />Elnclric Gas Olhcr <br />:G71 <br />3 - ao -07 <br />PERMIT p <br />� te i'i l�a�� //% <br />Y21P PHONE <br />�UC/'CU l��L�A yiZJ�'„jJ.j-]�I <br />-� PHONE <br />CITY2IP PHONE <br />I CONTRACT PRICE OF WORK <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas piping <br />Wal�n c�ater <br />Gas /ireplace <br />G�s ranc�o <br />Clothes dryor <br />Rangohood <br />Ezhausifa� <br />Heat pump <br />Unil hoalor <br />Boiter <br />Relrigeration <br />Woadstove <br />Othor. _ <br />CITY OF EVERETT LOCAL SALES TA% COOE IS 7105 <br />I hnreby cerilify Ihal I have reaA and examined Ih�s application and know the samo to be true and correct. All provisions ol laws and <br />ordinaces �overnin� this typo of work will bo c�mplled wilh whelher spocified heroin or nol. Tha granlinq ol a permit does not presume <br />to give authority lo violale or canr.ei �ho provision ol any other state or local law re9ulating conslruction or ihe peAormance ol <br />consiruction. Thal I am authorized hy Ihe owner of Ihis property lo perlorm Iha wurk lor which applicalion is made and 1 comply wlih the <br />State Contractors Law 1d�77 RCW and 29GT,00 WAC. <br />