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� <br />� <br />PERMIT �►PPLICATIVN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-0810 - FAX 425-257-8857 - www.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />�.3o3s �rnon.t� <br />LEGAL LOTNO.0 BLOCK <br />DESC. J <br />TRACT <br />pARCEI TAX I.D. N <br />P�RMIT # <br />0 <br />UwntX . ?: / /�ruunwo ..i � �,.�� rr,..�... �.� � 1'S''1�'+-7p��N <br />�%l�Llf� %C.Y� Qy'f� !�G/UE'�/02 �Q.�Q�M'f�(i�P.lLf 9�s"�O <br />TENANT NAME CONTACT FOR PERMIT PMONE <br />�l'�'"'�La l��/,eJ �fZS -75�- /S�� <br />CONTRACTOR L. /Im� <br />j�L(� <br />CONTR. LICENSE N <br />���C <br />USE OF BUILUING <br />WORK D SCRIPTION <br />�:�'"� a� s <br />NO. I TYPE OF FIXTURE OR ITEM <br />-S Toilet <br />�8athtub <br />. Levatory (wash basm) <br />/ Sh�Wt� <br />_ ! Kitchen sink 8 tlisposal <br />_ � Dishwasher <br />, � Clothes washer <br />_ Laundry iray <br />Smk (servicePoadmop/etc ) <br />BackOow preventer <br />Urinal <br />Dnnking Pountam <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />pDORESS " CITYIZIP ��� P,H�O^NpE <br />� 7/.J ' / � <br />9s�� 5��.(/�/oz, (��c�,.�'�tiv� <br />w� <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />_ Elec�ric �as _ Other � <br />NO. I TYCE OF FIXTURE OR ITEM <br />A/C - air handh�ig units <br />= Forced air systems <br />Gas piping <br />_ / _ Water heater <br />,�/ Gashreplace <br />/ I Gas range <br />_ ( Clothesdryer <br />— /- Range hooa <br />!� Exhausl fan <br />Heatpump <br />Unit heater <br />Boiler <br />Reingeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS J105 <br />I hereby cenhfy Ihat I have read and exammed this application and know Uie same to be irue and correct All provrsions of lavrs and <br />ordinaces goveming this type of work will be complied with whelher specified herein or nol The gran6ng of a permit does not presume <br />to give authonty to violate or cancel the provision ol nny olher state or lowl law regulatmg construction or the parlormance of <br />conslrucLon That I am authonzed by the owner ol lhis property to perform the work for which eppliwtion is made end I cnmp�y with ihe <br />State Contractors haw 27�4Vand 296 200 WAC <br />til�,l�� �f'•/� • D � <br />