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SITE ADDRESS <br />,�n,� -►5� <br />LOT NO. <br />PrRMIT APPLICATIt�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, 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.1! <br />BLOCK I TRACT OR SUBDIVISION ll <br />� —�b �Dg <br />PERMIT # <br />e��o - � � <br />DESC.j I_ I <br />OWNER ADDRESS CITY2IP PHONE �_� <br />���� F Mrarzc-►a �ea�s aon 75°fsrse E�c�� rr 4Fs�o3 355-yY <br />TENANT NAME � CONTACT FOR PERMIi PHONE �1a5'3,�5 yy �71 <br />, 7 o•v <br />�'r�rn� rlYlruTi a ,�hHNlci)� Sl�rrvlE e-rnru� -- <br />CONTR. LICENSE p <br />USE OF BUILDING <br />� I F1Ca LE <br />QV�1� i�_.�: <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />���a � _ �Electric ^Gas _ Uther 1 � 2�f.5_ <br />_ , <br />WORKDESCRIPTION �NU(__QTiNC) UNF��JISHI'.-D <br />PLUMBING <br />N0. TYPE OF FIXTUHE OR ITEM <br />.1_ <br />Toilet <br />Oalhtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwashor <br />CloUies washer <br />Walcr hoater <br />Sink (scrviceNadmop/t�lc.) <br />Oackllow preventer <br />Urinal <br />Drinkiny Founlain <br />Floor drain <br />Grease trap <br />Rool drains <br />Olher _ _ <br />. ,•-�.. <br />U I nJ�i .�/�C.t Lt�l %t'f %11'i <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Walcr hoa�or <br />Gas (ireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust (an <br />Hcal pump <br />Unit healer <br />Boiler <br />Ro(rigerallon <br />Woodstove <br />CITY OF CVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritily Iliat I have road and examined Ihis arplication and know Iho same lo be lrue and correct. All provisions ol laws and <br />ordinaces govr.min� Ihis type ol work will be complied wilh whelher specilied horoln or not. The granting of a permit does nol prosume <br />to qivo authority to violato or cancel ihe provision ol any o�hm slate or local law regulating construclion or Iho partormance ol <br />construction. That I am aulhorized by Ihe owner of this property to perform the work lor which appliwtion is mada and I comply with the <br />Slal� un rac}f �s Law 18.27 RCW and 2�Jf.200 WAC. <br />�Yw lL�... . _ � ����Y <br />L/ <br />�i _. __... _..___ .._. <br />