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SITE ADDRESS <br />� . <br />ifGA LOTNO. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVIC�S <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 — FAX 425-257-8F357 — www.everetiwa.org <br />APPIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� PARCEL TA% LD. p <br />� � . <br />__ I i�.i. <br />���-a� <br />l�-M�l.r� `���� <br />BLOCK � TRACT 08 SUBOIVISION 0 . <br />�( � � � � �� �'.r'� � ���I�l ( f�.�i <br />, - � �I C�-.,It�I4�:�� �I1,1i"1'12�., <br />_ l'r �1 � i: �- ra��.. i,. � <br />TENANi NAME I CONTACT FOR PERMIi PHONE ,. . 1'� �� i�) i0 i�/'-'— <br />r i,{ E•MAIL !. �.� � :•, � �, � �� !. <br />-7`.7SATR7I�TZSii � � , _ „ � � ..� . �', � f .., �, , . � i , , � , � , , r, . t <br />F , �� � „ � �� �� . , <br />CONTR.LICENSEX `'�� _ � , <br />;i.',•���_.� ��'!..r'�. r�'.,i�i _ <br />USE OF BUILDIN6 HEAT SOURCE — I CONTRACT PRICE OP WOFK <br />,,��i.: ���,i, �, �+�,.�:i�,�r�,.�,� -- � L <br />Eleclric Gas _ _ Olhr,r <br />.�,r. <br />WORK DESCRIPTION <br />��..'l�)��. � �;'�� �. : 1!rl� ( <br />L <br />I �10. <br />I- . .. - Toilal <br />Oalhtub <br />� Lava�ory�wash basin) <br />, Shower <br />Kilchen �.inh 8 disposal <br />nisbwashar <br />CluYies waslie� <br />�' Watar heater <br />Sink (service/barim.oplo�:.l <br />' Rscnllow pravenl�r <br />Urinal <br />� Orinkinp Poun�am <br />- Floor drdin <br />Grease lirip <br />flool drains <br />--- p�her --_ .. <br />TYPE Of IIXTUfiE OR IIEM <br />ryp, I TYPE (.F FIXTURE OH REM <br />'. <br />A!C - air hardling ud�is <br />Forced air systems <br />Gas p�ping <br />Water healer <br />Gas fireplace <br />Gasrange <br />Clothes dryei <br />Ranpe hood <br />Exhaust fen <br />Hoal pump <br />Unil healer <br />eous� <br />Flelrigerelion <br />Woodstove <br />Olher------ -_.— <br />I CITY OF EVERE'TT LQCAL SALES TAX CODE IS 9105 <br />1 hereby cerilily Ihat I heve read and examhiad �his t�pplicalion end krww the same to be Irue and corred. All provisions of laws end <br />Iordinacos goveming Ihis ty{m ol work witl bo complied with whelhor specified herein or nol. The grenti�p ol a permil does nol presumo <br />In give authanty In violale or cancel Iho prowsion of eny elher stata or local law regulaling cons�mcfion or lhe pertormance ol <br />� aonslruclion. Thal I am eull�orized by Iho owner ol th;s propeAy to perinrm the work lor which applicalion is made and I comply wilh lhe <br />iS�nte Coniractors Law 182� RCW erxl 286,200 WAC. <br />i 1 i , <br />ipnature o ar/ onlrector/ ut orize �ent �� ale <br />�� <br />,, <br />