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SITE ADDRFSS <br />� <br />LEGA LOT NO. / <br />�ESC. <br />.-ENANTNAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICCS <br />3200 CEDA i STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -- www.everetiwa.org <br />APPLICATIONS AHE ACCEPTED FROM 8 AM TO 4 PM <br />BS� <br />PARCELTAXID.p <br />�2 <br />TRACT OR SUBDIVISION N <br />eooaess ��KEIP�LACE'�E _ <br />+1� S'f SE <br />CONiACT FOR PEPMIT <br />r�:r.��� <br />I E-MAIL <br />T.aATRA�T6f� — —�ITViZf�'�6AbTR <br />i.toRv�c_ s��u�c�s q�,18 Mi�i�4.<< �a l�ci .,G�s��s� <br />CONTR. LICENSE N ��/s�O3 <br />IJo2D1511gOQA_ — �� - <br />USE OF BUILDING I HEAT SOURCE I� CONTRACT PRICE OF WORK <br />SF D <br />WORK DESCRIPTION <br />�Electric _ Gas_Othr.r I� � �'g� �O� <br />�1(LE I�ANnp�L'7E �EI��IR <br />��r•.we 4'�ep�aee �ee� S�sfe.w� <br />NO. I TVPE OF FII(TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin� <br />Showcr <br />Kilchen sink 8 disposai <br />Dishwasher <br />Clothes washcr <br />Waler heater <br />Sink (scrvicc/barimop/etc.) <br />Backllow provenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasc trap <br />Rool drains <br />Olher <br />Full � nter�o� c-p.elo�.er�v.�- <br />T— MECHANICAL <br />NO. I TYPE OF FIXTUPE OR ITEM <br />J– <br />—L <br />� <br />0.iC - air ��andling units <br />Fcrced air systems <br />Gas p�ping <br />Waler I�eater <br />Gas limplace <br />Gasrange <br />Clolhes drycr <br />Range hood <br />Exhaustlan <br />Hcat purrp <br />Unit hcatcr <br />Boilcr <br />Rclriacration <br />Woodstove <br />CITY OF E\�ERETT LOCAL SALES TA%COOE IS �105 <br />I hereby ceriUly Iha� 1 have read and e.amined ihis application and know Ihe same to bo irue and correcL All provisions ol laws and <br />o�d�naces governing Ihis type of work will bo complied with whelher specilied herein or nol. Tho gran�inp ol a permit daes nol presume <br />to qrve aulhorit violate or cancel,fhe provision ol any olher state or local law regulating consiruction or ihe pedormance ol <br />construcuon. a1 I m authorized by Ihe o�.��^r ol Ihis property to perlorm �hG work br �vhich appliwtion ;s mado and I compty with Ihe <br />S te Camre y�, 1827 RC�� d 296.N0 WAC. <br />/ l /i, � i/n�i,� 5�5/�a <br />