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317E ADDRESS <br />��- <br />LEGA ' LOT NO. <br />DESC <br />OVYNER <br />♦ y�, '� , <br />I / � � r✓ <br />TENANTNAME <br />A <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S1'REET, EVERETT, WA 98201 <br />425-257-8810 — FAX �i25-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �O `-/S "ID <br />PARCEL TAX I.U. !' PE MIT q <br />�I i`�� � t � -. <br />ALOCK TRACT OR SUBDIVISION K <br />ADDRESS CITY/ZIP PHONE tf,2S" 7�5 �_ <br />�)C/✓i3i'�C� �.� %/ �C��v �^!i C �.c<'2�//G�.��/�� <br />, , __ `, <br />t,I/, �ll� % il,G;-�-,-�� / <br />^.ONTR. LICENSE M <br />USE OF BUILDING <br />. ( -�'�: �.�:� /,-, , , ,, � <br />WORK DE3CRIPTION <br />%IJ �/; N <br />PLUMBING <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory pvash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mopletc.) <br />13ackllaw preventer <br />Urinal <br />Drinking Poun�ain <br />Flnor drain <br />Grease Vap <br />Roof drains <br />Other <br />CONTACT FOR PERMIT <br />� 1�,,� <br />97 <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />[lectric =/s _ Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC �• air handling units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Range hood <br />Exhnust (an <br />Heat pump <br />Unit heater <br />Boiler <br />_ Relrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA% CODE 19 J105 <br />I hereby ceAify thal I havd read and ex2miaed this application and know Ihe same lo be Irue and correr.t. All provisions ollawa and <br />ordmances goaeming a�s lype ol work wiil be complied with whether specified herein or not. The grantin� ol e permil does not presume <br />to give aulhority to vidale or cnncel Ihe provision of Tny other slale or local law regufating wns6uclion or the pedormance ol <br />conslruclion. That I am authorized by Ihe owner of this property to perlorm Ihe work for which application ia made and I comply with lhe <br />Slale Contractors Law 18,27 RCW and 290.200 WAC. <br />'�'.,J��, ti �.�-�✓ i �' -,'S=/L� <br />,.:__".." _. �...'_'in__.. _._.in..��._.:�_w n......� n.de <br />