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( <br />� <br />PERMIT APPLICATION <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 />SITE ADDRESS <br />�I� ���� <br />LEGA LOT N0. <br />DESG %7 � <br />OWNER <br />�1 <br />�r�c� � leac i Sn�� <br />TENANTNAME <br />n -�II(Ai iA`� <br />NPLu �� NSf RU�."P U N <br />CONTR. LICENSE � <br />NAL6CC. <br />�SE OF BUILDING <br />�inm��ura� � <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM �i � � 4� `�O <br />PARCEL TAX I.D. N <br />�.., „ .., . <br />BLOCK I RACi ORSUBDIVISIONi <br />2 �c;NTRa� i ae� <br />ADDRE55 <br />{ Il,-Z1 �C;eTM ST �4 <br />CONTACT FOR PERMIT <br />��PPL I '�l.,j�('�1l.IF'vk'_� <br />Zc�ij FIEw�n AvG <br />� <br />HEATSOURCE <br />PERMIT K <br />% C7)il�C� . �(�C `��vi� <br />An� r L.i��Qcr� �.i� oc.�� <br />CITYIZIP PHONE <br />CvGCi"R <br />' 4h�u�t— <br />PHONE Zj.j F-J.� �-'s �' <br />E�IINL �Ja�NiCIL�JIf7.�CI��. � � <br />I <br />CvEec TT <br />I CONTRACT PRICE OF WORK <br />_ Electric L Gas _ Other <br />WORK DESCRIPTION (,�N�,;t.i.S r <br />�rn,c�i � 1�—c� �A�c I�rn.r�c:-6� ll�A��S, �-rteCCR�t�+T CU-.�J�.�c—, _ , <br />- Y� 1ct� ��C-�N���-��_ �� �c:LNU2 Cir ��4�- �Ur_ � u <br />�visa.'� Tc I p <br />�'' H�c�C � ti���1_ ..., iucr.NeNics� <br />Np, I TYPE OF FIXTURE OR ITEM �L��: (;� L4'�,� I N�• <br />Toilet <br />BalMu6 <br />Lavatory (wash basin) <br />Shower <br />Kdchen sink & disposal <br />Dishwas'�er <br />Clothes was:�er <br />Waier heater <br />Sink (servicelbadmnp/e�t. ) <br />BackOow preventer <br />Urinal <br />Drmking Founlain <br />Floor drain <br />3rease trap <br />Roof drains <br />Other <br />TYPE OF FIXTURE OR ITEM �',�',� �u�, �( <br />AIC - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas Greplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heatpump <br />Unit healer <br />Boiler <br />Refngeration <br />Wood5love <br />CITY OF EVcRETf IOCAL SALES TA% CODE IS J105 <br />II hereby certify that I have read and ezamined this application and know the same to be We and correct. All pmwsions of laws and <br />ordinances governing ihis type of work will be complied with whether specified herein or not. The 5ranting of a permit does nol presume <br />Itn gwe a�thonry to wolate or cancel ihe provision of any other siate or local law mguWling construction or the peAormance o( <br />construchon._That I am authorized by the owner ef this propeAy to perlorm the work for whlch application is made and I comply with the <br />State Contraclbrs Law 18 27 RCW and 296.<^00 WAC. <br />I <br />�- -- <br />�IZ <br />