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SiTE ADDRESS <br />� <br />IhGN LOTNO. <br />i�isc � <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERET7, WA 98201 <br />4? ;-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLIC:ATIONS ARE ACCEPTcO FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. p <br />f7'�'" � <br />t �.�.� . . <br />BLOCK iRACT OR SUBDIVISION 0 <br />�� � �l ...� . ' �t <br />� �. , <br />+�.ln-, ( ��y{ <br />6 <br />C� <br />(�cr.l� \ <br />��i�.. ' � liit � ��r �� f���,L�.. �.i i � i ��,(11��('li`� ��1�'> 11� �"i'i_ <br />I _ <br />TENANT NO.MF. I CONTACT FOR PEHMIT PHONE �, �. ,"- ,,} ip r�j'( <br />�,'.�i,q � � E-MNL .,� �' _• (�' ��,mul �x. <br />��bF7TR' � � . , � . . r' i r . �Sf{E53 CITV7l1R--PRbA� 1 <br />„ �, � � ���_. <br />.4 �.. ,.,. �.... i� , -, ' <br />COKfR. UCENSE �t '` � . <br />.r• ' �,i �_�4'. !� ��,.r'� . r, . <br />USE OF BUILDING <br />,.r �t i� �ii I� i��l.,�l��:l( . � <br />� �� _.. <br />WORK DESCRIPTION <br />� .,���r. � <br />.) <br />PLUMBING <br />NO TYPE OF FIYTURE Ofi ITEh� <br />Toilol <br />�' Balhfub <br />j� _ LAvalory (Wash t;a+;inl <br />Shower <br />Kilchen sink 8 dispoe,�:i <br />' Dishwa:hei <br />Clolhoc washe� <br />�_ Waterheater <br />Sinh (servicelbarlmop/r,i�..) <br />_' Ciackllowpreventer <br />Urinel <br />Drinking Fount�;•�� <br />- Floor dram <br />i Giease trap <br />Ij Roof drains <br />i <br />Olhdr . _ <br />� _._ <br />I <br />� <br />HEATSOURCE <br />_._ Eleclric __ __. Gas _ Othei <br />�� <br />i �_- .� <br />CONTRACT PRICE OF WOfiK <br />1�0 I TYPE OF FIX7UFE OR ITEM <br />� <br />1 <br />� <br />� <br />� <br />J <br />I NC - air hardling unils <br />IForcod air syslems <br />Gas piping <br />� Water healer <br />Gas fireplace <br />Gas range <br />Ciothes dryer <br />Ranpe hood <br />Exhausl fen <br />Hoat pwnp <br />Unit heater <br />Boilor <br />Refriyertilion <br />Woadstove <br />Other_--- —_---_ _ <br />CITY OF EVERE7T LOCAL BALES TA7f CODE IS 3105 <br />I hereby ceritity that I huve reaA and examined Ihis epplicahon and krqw Om seme to be irue arxJ correct. All provisions ol laws and <br />ordinar,es governing Ihis �ype o( w„rk will be complied wlth whathe� specified he�ein or nol. The grantlng ol a permit does nal presume <br />lu pive aidhority lo viotale or cancel Iho provision of any othe� stele or locet 12w regu�a6ng construcfion or lhe perlormance of <br />conslruclion. That I em authorizad by Ihe owner ol �his property to peAorm the wnrk lor which eppticalion is made and I compty with ihF <br />Slate Contractors Law 18.27 RCW nnd 256200 WAC. <br />t � � <br />I i Nre o ner ontrector ut �onz genl �; � � a� / <br />t � <br />� <br />