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SITE ADDRESS <br />7o�j L7�� $�. Sfv <br />�'v tw <br />PARCEL TAX I.D. A <br />I ei5 y ,23Dpoon „ <br />PER A <br />'" <br />LEGA LOT NO. <br />% <br />BLOCK <br />TRACT OR SUBDIVISION .L nn <br />1 <br />DESC. <br />(,XiO n-QDJlrra <br />I"iirl� <br />OWNER ADDRESS S�CITY21 d 9$ PHONE <br />f~ <br />a o 51 r ,'fin i1,'[.� J <br />TAG <In e � (J � (� c� m�u�i�,, <br />TENANT NAME FOR PERMIT PH ,r ,�Z <br />/CONTACT 1/,2 <br />cirTvt G^2S E-MinSn.cC, <br />L`3RTIib � - <br />lG%� /t'' f{'rerc-7t 10 .N 7/7 �L't'rgC ��. <br />CONTR. LICENSE A ruRC�/C log� r�{o <br />1.3 <br />USE OF BUILDING <br />HEAT SOURCE <br />o.. <br />CONTRACT PRICE OF WORK <br />/ <br />r�e'r Cur YCn'7 r�li' <br />ElecMc —Gas —Other <br />,. eM <br />WORK DESCRIPTION �,,iK o n �v,er- p<1 �� - y.CWrUV,%� f � Q1r13'>`� � GitffrlrlpS <br />l <br />����lncr'..g wr tti 9new ��te,,.,a� C Ir'ke �'�� (rK� r.� S�,.o/%. i.• S;zc> <br />err„I <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />N0. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C -air handling units <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_Gas <br />piping A/� <br />Water healer <br />Shower <br />Kitchen sink 8 disposal //'� <br />Gas fireplace <br />_ <br />Dishwasher l /4 <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Wafer heater <br />Range hood <br />Sink (servlcerbarlmop/olc.) <br />Exhaust fan <br />Backflow prevontor <br />_Heat <br />pump <br />_ <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Refrigeration <br />_ <br />I.T. <br />Floor drain <br />Grease trap <br />Woodstove /J!� <br />v <br />— <br />Ydrains <br />Roof <br />=Other <br />_ <br />q,oe <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceritlfy that I have road and examined this application and know the same to be true and corroct. All provisions of laws and <br />"S correct. All <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting el a permit dons not presume <br />.".'^ <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Slate Contract ew 1627 RC and 6.200 WAC. <br />D �c' /,f� vo 7 <br />k <br />Signature of Ownor/Contractor/ uthodzo goof r eta <br />IZ <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8310 —FAX 425-257-8357 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />