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PERMIT APPLtCATIQN <br /> C1T'Y' OF EV�RET'T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7',WA 98201 <br /> 425-257-8810—FAX 42�257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AAA TO 4 PM � � / �� � <br /> Sf�TE^ADDRESS( � j.� {�' R PARCEL TAX I.D.0 PERMR t <br /> L[/� Lf�� /t�`7 {�1" '/� E7' 28n5Z`tar�2dL'kx� il�'�(��� - r�'l�' <br /> LtG LOTNO BLOCK TR^I1C�aN �IV� L- <br /> �� , ��'C. � <br /> DESG ���o_,�,`? <br /> pyyN� � ADDRESS CffN21P PHONE <br /> �i I I vW �z1� �l e1y 1�.�� U.(. I��o�' S�'cw� p� �+.ac.. �S�w Oic�,�A- <br /> 7ENMIT N E CONTACT FOR PERMR PHONE <br /> �►�� ��.��� I� ►��� ,a�� � . ������-- <br /> CON TOR � ���ADDR�5 � � �� CRYIDP PHONE <br /> S ��� &Ur.w�� �zs'•c�4��O4c� <br /> CONTR. EHSE i 1.'��� <br /> �k�f��_ Zur� �,,, <br /> USE OF BUILDING � �HEAT SOURCE s�ONTRACT PRICE OF WORK <br /> �.V� v�[.w1�-s I _vElectric _Gas_Other �1 (�I� �� 6� <br /> WORK DESCRIPTION <br /> �c�utvir f'G-std.cr� t {�res -� E�i(��s <br /> PLUMBING �,/ f+, MECHANICAL /J�.. <br /> NO. TYPE OF FlXTURE OR fTEM NO. 7YPE OF FIX.TURE OR fiEM - <br /> Toilet A/C-air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas pfping <br /> Shower Water healer <br /> Kilrhen sink 8 disposal Gas fireplace <br /> Dishwasher Gas ranga <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(servica/bar/mop/etc.) Exhaust tan <br /> BacMfow prevunter Heat pump <br /> Urinal Unit healer <br /> Drinking Fountain Boiler <br /> � Floord2in Refrigeration <br /> Grease trap Woodstove <br /> = Roofdrains ( — Other <br /> O�hor <br /> CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br /> I heraby ceriGfy that I have read and examined this applicatbn and know the same to be tn�e and cortect. All provisions of laws and <br /> ordinactZs goveming this type o(work will be complied witti whether spedfied herein or not.The granting of a pertnk does nol ptesume <br /> to give au�th 'ty to violate or cancel the provision of any oPhor state or local law regulatlng co�struction or the pe�fortnance ot <br /> cbnstn;clion. et m authori.ed by the owner ot this property to perfortn the wak for which appliption is made and I comply with the <br /> State Contrad CW and 296200 WAC. <br /> � �� <br /> Sign3turs o onVaclor/A Uwrized Agenl Da <br /> ��1 <br />