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SITE ADDRESS <br />� YU8' � <br />LEGAL LOT NO. <br />DESC. � <br />OWNER <br />'Vi/��L jYJ ; <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.U. # <br />� � (3l. V� 0�531 v� <br />BLOCK TRACT OR SUBDIVISION # <br />G yv� �3F. rGF'2c; <br />CI�NTACT FOR PBRMIT <br />�U/�N /f0< % <br />/�vL_T ;' Cvi✓6T. �'�/l', <br />CONTR. LICENSE # <br />h'vc� Fciv� <br />USE OF BUILDING <br />���s . ��I /t�� <br />WORK DESCRIPTION <br />Gr,Yi/l,�i <br />HEATSOURCE <br />� Electric _ Gas _ Olher <br />�� � o� � r � OI.J i J /CJ�l/ � �l� % � f � �7 (/I�-1 � �' I <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhtub <br />� Lavatory (wash basin) <br />� Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />� Clolhes washer <br />Water healer <br />� Sink (service/barhnop/elc.) <br />Back(low preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />O�her <br />PERMIT # <br />,o� . � -� <br />/ !%. :1 <br />�'—v 9fr2c�� �yas�.�s 3 - <br />PHONE/�7j 772' $�; <br />—c'raoa� �, r <br />Y"%�9%%�G•S=?O( ^� �1 <br />CONTRACT PRICE OF WORK <br />'���� Q�C7� , cl J <br />/>O 'd9 L' - <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling unils <br />Forced air syslems <br />Gas piping <br />VJater healer <br />Gas (ireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br />I hereby ceritity lhat I have read and examined this application and know lho same to bo lrue and correct. All provisions of laws and <br />ordinaces governir.g this lype o( work will 6e complied with whelhor speci(ied herein or not. The granling of a permil does not presuma <br />to give authority lo violate or cancel the provision ol any other state or local law regulaling construction or the performance of <br />conslruclion. Thal I am authorized by the owner of ihis property lo perlorm lhe work for which applicalion is made and 1 comply wilh lhe <br />Slate Co raclors Law 18.27 RCW and 296200 WAC. <br />��.,, �J�— 'S/�//a9 <br />t� <br />z <br />