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{ t�ERMIT APPLICAI �ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.t ERMIT/ <br /> i�l�� �e���+ � �a� - �sq <br /> LEGAL LOT N0. BLOCK TRACT OR SUBDIVISION N <br /> DESC. <br /> NER ADDRESS CITY2IP PMONE \�b O�j <br /> �Itic`�E�(.. S- �-J►'�n'�/� I°l4� S�i-r£ A �-IF_w,irpvE• �1zS-3� 8 <br /> C'VFi FTl Gvra �`icFZa I <br /> TENANT NAME CONTACT fOR PERMIT PHONE <br /> �F7F1� Sil��vc Atii �ur� iinN�on 4 LS �. �bo i� 69 <br /> v ' �5� t o E*IAIL ' <br /> CONTR.LICENSE# <br /> USE OF BUILDING NEAT SOURCE CONTRACT PRICE OF WORK <br /> S M/�k. (�17�til� _Eleclric _Gas_Other <br /> WORK DESCRIPTION <br /> /✓�a�i != 1 �Ayl u N �un� �n i��'�� �u �(-_'S-r.� ��C,�� <br /> PI_UMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM NO. T?E OF FIXTURE OR ITEM <br /> Toilel AIC—air handlirg units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kilchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink�servicelbar/mop/elc.) _ Exhauslfan <br /> Backilow prevenler _ Heal pump <br /> Urinal Unit healer <br /> Drinking Fountain _ Boiler <br /> Floor drain Refrigeralion <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Uther <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby cerilify thal I have read and examined this application and know lhe same lo be true and correct. All provfsions ot laws and <br /> ordinaces govemi�g Ihis rype of work will be compiied with whether specified herein or not.The granting o(a permit does not presume <br /> lo give aulhurily lo violate or cancel the provision of any other slate or local Iaw regulating conslruction or the peAortnance of <br /> construclion.That I am authorized by the owner of this property to periorm the work for which application is made and I wmply wilh the <br /> Slale Conlractors aw 1827 RCW and 296.2G0 WAC. <br /> ���%� vll� �w <br /> SignaWre ot OwnedCc 2ctodAuthorized Agenl ate / <br /> � z <br /> � --- � <br />