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SITE ADDRESS <br />���c�� � <br />LE LOT NO. <br />oesc. <br />7ENANTNAME <br />coNrRncroA Un�im� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERIMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-885? - www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM <br />� L <br />HLOCK <br />TRACT <br />PARCEL TAX I.D. N <br />Ne�ah+5 LL� 9tii. <br />L I CO� CT FOR PERMIT <br />✓� �'1 %�%� � <br />CONTR. LICENSE � UNLSM MII <br />USE OF BUILDING <br />✓t s i t�Q v� ii n j <br />WORK DESCRIPTION <br />� �uortess <br />+� s� <br />-- cmmP <br />PERMIT M <br />. Ko�o:� -�'�l <br />PHONEytS' 9j/-/�17D <br />4�asg <br />ioa L�� s���PN� <br />PHONE <br />�bo �- Gs7- al8 � <br />P��E �,o-HS �-�,�a <br />Pc f��X i�i5 "7 ��a� y� N Il� w� 98a � o <br />HEAT 30URCE I CONTRACT PRICE OF WORK <br />�o <br />_ Eledric _ Gas _ Ofher � 7 gQ <br />I.�r,{�il�niio.� [n aJ�mv.a�1�C �ir-< 5�f.��.�k.�rr sy6�oe� <br />NO. I TYPE OF FI%TUHE UR ITEM <br />TOIIBt <br />Bathtub <br />Lavatory (wash b:is�n) <br />Shower <br />Kitchen slnk 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry Iray <br />Sink (service/barlmopletc.) <br />Badcflow preventer <br />Unna1 <br />Drinking Fountain <br />Flaor drain <br />� Grease Irap <br />Rool drams <br />Other <br />NO. I TYPE OF FI%TURE OR ITEY <br />_ AIC - alr handling units <br />Faced air systems <br />Gas piping <br />Water healer <br />Gas (�replace <br />Gasrange <br />Clothes dryer <br />Rarge hood <br />Exhaust lan <br />Heat pump <br />Unit hea�er <br />Boiler <br />Rehigeranon <br />Wootlstove <br />Other <br />CITY OF EVERETT LOCAL 9AlES TAX CODE 19 7105 <br />I hereby ceritify that I have read and examine�: !his applicaUon and know the same to be true and oorred. All provisians of laws and <br />ordinaces goveming Ihis type ol wak will Le complled wtth whether spedfied herein a not. The grentlng of a pennd does rat prewme <br />to give authoriry to violate ur cancel the provlsion ol any other Etate a local law regulating consVuc6on a the performarke al <br />construction. That I am auttiaized by tl�e owner of ttiis property to perlwm the wak Ia� which application is made and 1 tomply with the <br />State Contradas Law 1027 RCJU and 296 200 WAC� � <br />/�'� J ' i• � ' : � � . , r <br />��L /� J /i , , � > � � <br />ignature�o�ied ontradod i anzed _ ent i at <br />