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SI''E ADDRE55 <br />LOT NO. <br />DESC <br />PERMIT APPLICATION <br />CITY OF EVCREI'T PERMIT SERVICES <br />3200 CEDNR STRE E f, EVERETT, WA 98201 <br />425-257-8810 — FAX 42:�-257-8657 — www.evoreriwa.org <br />APPUCA710NS ARE ACCEPTED FROM 8 AM TO 4 PM L��V ��5 '�� <br />PARCEL TAIf I.D. d pERM1T k <br />�o I /�%�,�-��; <br />BLOCK I TRACT,-: <br />6zlmoh�¢ N�oh�Or� LLC 9514 4�'.`�Ir�+NE,� <br />TENANTNAME r CONTACTFORPERMIT <br />3�.��t�.J��. <br />CONTRACTOR <br />CONTR. LICENSE N <br />USE OF BUILDWG <br />WORK DESCRIPTION <br />NO. I TVPE OF FIXTURE OR ITEM <br />� TOiIBI <br />Bathtub <br />. �� Lavatory (wash basin) <br />�� Shower <br />� Kitchen sink 8 disposal <br />� Dishwasher <br />� Clothes washer <br />Laundry tray <br />� Sink �semceibar/mop/etc 1 <br />' Backflow prevenler <br />Urinal <br />Drmking Fountain <br />Floor drain <br />Grease trap <br />Roof drams <br />Olher <br />AODRE9S <br />HEATSOURCE <br />_Electnc � Gas_Othei <br />IC # <br />N0. <br />r <br />ZP PNONE <br />�,a� iSaSB '1�59531y <br />PHONF <br />��Zs-�s4-isBB <br />CITY/ZIP PHONE <br />I CONTRACT PRICE OF WORK <br />TYPE OF FI%TURE OR ITEM <br />AIC — air handling units <br />Forced air systems <br />Ges piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Renge hood <br />Ezhaust lan <br />Heat pump <br />Unit iieeter <br />Boiler <br />ReMgeration <br />Woodstove <br />Olher_ <br />CITV OF EVERETT LOCAL SALES TA% CODE IS J106 <br />! I hereby cenlity Ihat I have read and examined Ihis application and know the same to be 4ue and corred. All provisions of laws and <br />ordinaces govemmg Ihis type ol work will be complied wnh whether speafied herein or not. The granting of a permit does nol presume <br />� to grv= authonty ro violate or cancel Ihe provision ol any other state or lowl law iegulating construction or the performence al <br />� r,onsiruction Thal I am auth�qr�i d by the owner ol this property to perfortn ihe work for which appliwfion is made and 1 comply with ihe <br />i State Coniractors LewJt�21�RC� and 296200 WAC. , <br />v <br />1,' <br />