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%Y 1 <br />� cRMIT AP'PLICATI'�. N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVFRETf, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — w�vw.everettwe.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���;� �] L' <br />SITE ADDRESS n <br />�y2- ,c�ln�o,��� (.����� <br />LEGAL LOTNO. /� BLOCK <br />DESC ��p <br />TRACT <br />PARCEL TAX I.D. k. PiR IT K <br />�% .�` G�G, ��-�-���1G- C-�C;'.�5-71' <br />.,..���/I�� %�'� �-� -..-�9'f� �it/E �jo2 ��- . . . _ <br />l�S�u�C/�r 9�3s�°' <br />TENANT NAME CON?ACT FOR PERMIT PFIONE <br />�r�tt'� (/o�heJ �zS-7s� -/s�'P <br />CON iTtACTOR �m,ry� �p � ;y ,�� ESS CITY2IP PMON / �O <br />sizs=�s3 • � <br />CONTR. LICEN E� v'V4�Q� ` 9�'� 5`�,C/�/oz, �Gt,�.�'�i�' �iA- <br />�E�..niahlL4U�fa� <br />USE OF BUILDING I HEAT SOURCE � CONTRACT PRICE OF WORK <br />WORK D SCRIPTION � <br />� � �3 <br />NO. I TYPE OF FIxTURE OR ITEM <br />� <br />Toilet <br />Bethtub <br />Lavatory (wash basin) <br />Shower <br />Nitchen sink 8 disposnl <br />Dishwasher <br />Clothes wasfier <br />Leuntlry tray <br />Sink (servicePoodmop/etc ) <br />Beckflow preventer <br />Urinal <br />Dnnking Pountain <br />Floor drain <br />Grease �rep <br />Root drains <br />Othet <br />_ �lectnc ✓ Ges _ Olher <br />; <br />� _ <br />MECHANICAL <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — air ;iandling units <br />� �Forced air system5 <br />Gas piping <br />�/-:L, Waterheater <br />1_ Gas hreplace <br />1_ Gas renge <br />J_ Clothes dryer <br />1 �:ange hood <br />� Exheustfan <br />_ Heat pump <br />Unit heater <br />' Boiler <br />Reingeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �106 <br />I hereby ceriufy that ! have read and exemmed this appGcation and know the same to be lrue end correct. All provisions al lews and <br />ordinaces goveminy lhis rype ol work will be compiied with whether speci6ed herein or noL The granting ol e permft does no! presume <br />to give euthonty to violate or cancel the provlsion ol any other state or local law reguleting constmdion or the peAormence ot <br />construdion. That I am eulhonzed by the nwner ol this propeAy to perfortn the work for which application is mede and I comply vnth lhe <br />Sta�e Contractqs Law J 827 RCW and 296200 WAC , <br />/lc•L <br />