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PERMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 I D`� Z�� <br />425-257-8810 — FAX 425-257-8857 — wvrvu.evereltwa.org <br />�ITE ADORESS <br />� ���.. < <.c..1 e'� <br />LEGAL LOT NO. <br />DESC.I <br />Kr�s� � t�l���� <br />TENANTNAME <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />L-L.�_ <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION tt <br />CONTACT FOR PERMIT <br />�� l a -� � <br />PERMIT ii <br />1�,'Fs l l� C�, <br />PHONE r ('L � 3 yYi $' \ <br />� - - �" L E•MAIL <br />ONTRACTO � ADD SS CI Y/ IP H <br />��1<`I�EZt�/t.�'` LLUUnC�rN�r,[l��C l(ca\7l I(;`1�A�.1'VWL.���2 ��8�7� <br />CONTR. LICENSE� J ' � � ?)C,�j •-T�'�(- �j� �-.7� <br />.�tS,[��('ti��,Gc�r� l��= 2610 � <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />C7'Kl C�'- `S _ Eledric _ Gas _ Other <br />WORK DESCRIPTION <br />' �U�����\G'\ <br />U <br />NPE OF FIXTURE OR ITEM <br />Toilel <br />Ba1hWb <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwashcr <br />Clolhes washcr <br />Water healer <br />Sink (service/bar/mop/e�c.) <br />Backflow preventer <br />Urinal <br />Qrinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ __ <br />N0. I TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas lireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhauslfan <br />Heatpump <br />Unit healer <br />Boiler <br />Refric�erelion <br />Woodstove <br />CITY OF EVERElT LOCAL SALES TAX CODE IS 3705 <br />I hereby cerihfy Ihat I have read and examined this applicalion and krrnv the same to be irue and correcl. All provisions ol laws and I <br />ordinaces goveming this type ol work will be complied with whelher specified herein or noL The granting of a permit does nol presume <br />to give aulhoriry to violate or cancel ihe provision ol any other stale or local law regulaling consiruction or ihe perormance ot I <br />consl tion. That I am authorized by the owner of this property lo perform lhe work lor which applicalion is made and I comply with the <br />St e Co lractors Law 18.27 RCW hd29G.200 WAC. I <br />7 i <br />j. �.. -- — _ �t-._-�_ L�— U Z "�7_� . � {�_� <br />��ig �tu� o( Ow er/Co}Nfa dNulhorized Agenl Datc� `� � <br />l. � i\� <br />� � <br />