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PtRMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES ` , <br />3200 CEDAR STREET, EVERETT, WA 96201 J' � <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE <br />NO. I BLOCK <br />TENANT <br />CONTR.LICENSE# �/OA^�1 ��Y <br />C— 1 <br />USE OF BUILDING <br />WORK DESCRIPT�ON <br />I PARCEL TAl( I.D. N <br />� ��Z � <br />TRACT OR SUBD�VISION K <br />FOR <br />PHONE <br />PERMIT M <br />ADDRE55 GITY/ZIP PNI <br />�7Z� � �' C'L,Se, �e/%vue <br />3o m <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhlub <br />Lavalory (wash basin) <br />Shower <br />Kilclien sink 8 disposal <br />Dishwasher <br />Clothes washer <br />VJaler heater <br />Sink (service/badmop/elc.) <br />BackOow pravenler <br />Uri�al <br />Drmking Founlain <br />Floor drain <br />Grease Irap <br />Roof drains <br />Olher <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Eleclric Gas Other <br />� <br />NO. I TYP[ OF FIXTURE OR ITEM <br />A/C — air handling units <br />rorced air syslems <br />Gas piping <br />Waler healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausltan <br />Heat pump <br />Unit healer <br />Boiler <br />Reirigeration <br />Woodstove <br />Olher <br />CITY OF EVERETf IOCAL SALES TIU( CODE IS 3105 <br />I heroby cerilify that I have read and examined this application and Y.now tLa same to be true and correcl All provisions of laws and <br />ordinaces governinc� this type of work will be complied wilh whelher speci(ied herein or not The granling of a permil does nol presume <br />lo give authonry lo violale or cancel the provision of any other slale or local law regulaling construction or the performan�e of <br />construction. Th I am aulhorized by the owner of this property to perform lhe work for which application is made aad I comply wilh the <br />Stale Contrac rs Law 18.27 RCW and 296.200 WAC. <br />- — =.i�.. _ ' 6'z/ /o� <br />