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SITE ADDRESS <br />7�/O `F ` U� <br />LEGA LOT NO. <br />DESC. <br />� <br />P(cRMli' APRLICATlON <br />CITY OF EVERETT PERIVIIT SERVICES <br />3200 CEDAR STREET, EVERETI', WA 98201 <br />425-257-8810 — i�AX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />c eh �✓!d�( � <br />BLOCK TRACT <br />S��a; h �i s �, <br />TENANTNAME <br />f, �, N�,� �d w ����n <br />CONTRACTOR S � �„ �Q V,- [ w✓it •,,r, (l <br />CONTR. LICENSE # <br />USE OF BUILDING <br />S�G�S <br />WORK �ESCRIPTION <br />�/) �t� c� t i <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />PARCEL TAX I.D. # <br />Z 3/-7 �����,V�� <br />CONTACT FOR PERMIT <br />� M��FIMtI �c'H/�� <br />ADDRESS 9� � �"( P!-(ii <br />HEATSOURCE <br />Eleclric _ Gas _ Olher <br />CVirC i 1 <br />y <br />�Q CITY21P�j �Z S 3 <br />PERMIT7F <br />g�5o <br />PHONE <br />Z9'-330-9�75/ <br />PHONEr�L7 C, S�OS:C <br />CONTRACT PRICE OF WORK <br />�Sa�- �� <br />NO. I TYPE OF FIXTURB OR ITEM <br />A/C — air handling units <br />Forced afr syslems <br />Gas pip(ng <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range liood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretion <br />Woodslove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and cortect. All provisions of laws and <br />ordinaces goveming this rype ot work will be complied with whelher specified herein or not The granling of a permit does not presume <br />to give authorily to violale or cancel lhe provision of any olher slate or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of thls property to perfortn the work for which applicaGon is made and I comply with lhe <br />Slate Conlractors I:aw 18.27 RCW and 296.200 WAC. <br />< <br />� <br />