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PERMIT A�PLICATION <br />CITY OF EVERE7,T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 - FAX 426-257-8657 - www.everettwa.org <br />APPIICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />SRE ADDRESS r <br />..(o��-{ �oc.,<.e TC��?� <br />IEGA LOT NO. BLOCK <br />DESC. <br />OWNER <br />Fron��er Com�t���c.c.}-��nS <br />HAME <br />F�on1'�e� GoMM�.1iGc�'I";onS <br />51"�Gi-ebiG <br />coKrx. ucensE � <br />USE OF BUILDING <br />S 7�nG �e <br />Go M N� U A( CA.%i o�lS <br />WORK DESCRIPTION <br />PARCEL TAX I.D. / <br />TRACT OR SUBdVIS�OM I <br />a ���bh eid� P4'k <br />CONTACTFORPERMR <br />Mutt' Lon� <br />I2 (pfpOfw <br />S�4M��d,cr o6yos <br />M <br />m <br />StY-bl�-Ibb7 <br />P�,E sia-bi8 - iee <br />Orr�c. c��F�on'Pti�k�Ny <br />� <br />sia-eia-i�7� <br />— HEAT SOURCE I COn7Rwc � recn:c vr ..vnn <br />Electric _Gas Olher "1 �� <br />(Ce nw ve. (�2.r i Zd�,� 5;&+1 �.� 2 <br />NO. � TVPE OF FlXTURE OR REM <br />Toilet <br />Bathlub <br />Lavatory (wash bas��) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbaqmoplelc.) <br />BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Rool drains <br />Other <br />and �nsi�l� Fra�t�-i'e� s�s�t <br />NO. I TYPE OF FlXTURE OR REM <br />AIC - air handlirg uniLs <br />Forced air syslems <br />Gas pping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryar <br />Range hood <br />Exhauslfan <br />Fieat pump <br />Unit heater <br />Boiler <br />Relrigera�ion <br />Woodstova <br />Olher <br />CITY bF EVERETT LOCAL SALES TA7( CODE IS �105 <br />I hereby certify that I heve read and examineC this application and know lhe same 10 be true and correct. All provisions ol laws and <br />ordinances governinc� this rype of work will be complied with whether specified herein or noL The grenting of a permit does not presume <br />to givo authority to violate or cancel the pmvision of any other state or local law regulating construcGon or the perfortnance o( <br />construction. Thal I am authonzed by the owner o( this property to perform the work for which application is made and I comply with the <br />Staie Contr2ctors Law 18.27 RCW and 296200 WAC. <br />— � U'I <br />Signature ot �wnedContracror/A er Agent Date �/` <br />