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� <br />�D Z.� � <br />LEGAL LOfNO/-�� <br />DESC / (J <br />� <br />NERMIT APPLlCATIt�N <br />CITY OF EVERETT PEFtMIT SERVICES <br />320� CEDP.R STREET, EVEFETT, WA 98201 <br />425-257-8810 �- FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM % 1�.�/�� �)�-, <br />tl <br />/^ PARCEL TAX I.D. N <br />� [�.n� <br />BLOCK TRACT <br />oWNERL� Am� k� //�vuuncaa 1�.i� r�ur rn�n� fr�s y��.�.�-� <br />vxY R�s� ���UE �oz (��ueitr 9��s'� <br />TENANT NAME CONTACT FOR PERMIT PHONE op <br />CJ�6JC'1-Gc VvaS�l%iC/ �� �������QQ <br />CONTAACTOR �,n�,,,� <br />CnNTR. LICENSE N�E��� �y�& <br />USE OF BUILDING <br />WORK D SC` � RIPTION � <br />L�[JL[� � 5`� <br />NO. I TYPE OF FI%TURE OR ITEM <br />�} _ Toile� <br />,_,;�_ Bathtub <br />_Lf-, Lava�ory (wash basin� <br />_/ Shower <br />/ Kitr,hen sink 8 disposal <br />/ Dishwasher <br />. I Clothes wasfier <br />, Laundry tiay <br />Sink (servicelbadmopletc � <br />BackAow preventer <br />Unnal <br />Dnnking Pountam <br />Floor drain <br />Grease trap <br />Rool drains <br />Other <br />�DDRE55 � CITYIZIP PHON <br />�" s�2S-�S3 ••�?v <br />Cf 5/5f �i� iC/�/OZ� �2��o�f/0_/W' 1f��4 <br />HEAT SOURCE I CONTRACT PRICE OF WORK <br />Eler.tric ✓ Gas Other <br />�'. i <br />�:{, —� <br />I:P71 <br />TYPE OF FI%TURE OR ITEM <br />A/C - air handling unitc <br />Forced ah systems <br />Gas piping <br />Waler heater <br />Gas fueplace <br />Gasrange <br />Clothes dryer <br />P,ange hood <br />Fxhausllan <br />Heatpump <br />Unit heater <br />Boiler <br />Refngeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceri6fy that I have read and exammed this apphcahon and know ihe same to be true and correct. All provisions of lavrs and <br />ordinaces governing this �ype ol work wdl be complied with whether speGfietl herein or nol. The granling of a permit does not presume <br />to g�ve aulhonty to violate or cancel the provision ol any other s�ale or local law regulating cor.struchon or the performance of <br />construction That I am authorrzed by ihe owner of �his property to peAorm the work for which application is made end I comply with the <br />State Coniradors Law 18 27 RCW and 296 200 WAC <br />