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P�RMIT APPLICATIVN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everattwa.org <br />APPLICATIONS ARE ACCEP'fED FROM 6 AM TO 4 PM <br />>� �`�' �t) �-eC � v� I� V li <br />LOT IIO. LO(:K <br />pESC. <br />PARCEL TAX I.D. # <br />TRACT OR °UBDIVISION N <br />PERMIT # <br />IY�a 7�u-o�CJ <br />vrvntR nwnwa �.n vur rnvnc � �� <br />��SA ��K�SIK ��D3U �-'J�cI„��/�JIJD �Jd�r�lf%k7o3 �'9�7(d. <br />TENANT NAME CONTACT FOR PERMIT PHONE y�,-,s o�,�s� <br />— �—lS� �K/-�SI� E•MAIL �� <br />curvinncwn Ki `Klr�t-nD <br />CONTR. LICENSE # F� �I�� <br />FirEPs� o <br />USE OF BUILDING <br />Rp�,�,ti� <br />Sl1(�J'�'j .T�^'� C: <br />� � � 1� � ,►,a <br />'/�-7ooiyG <br />� ay'"� �� , <br />1�" ' HEAT SOURCE <br />_ Electric �Gas _ Other <br />.iii�cir rnurvc ��_ ��I <br />� r ��r <br />K �So�u y"�oc� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION • � �� (v�� <br />/� DD �r�e�s-I�D� �5 L7As S� d e �v�. MAs�-' <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwashcr <br />Clothes washer <br />Watur heater <br />Sink (service/barlmop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Greaso lrap <br />Roof drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fimplace <br />Gas rango <br />Clothes dryer <br />Rangehood <br />Exhaust (an <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby cerili(y ihat I have read and examined this ap�lication and know the same ro be Irue and correct. All provisions of laws and <br />ordinaces governing ihis rype ol work will bo complieu wilh xhelher specifind herein or not. Tho granling of a permil does not presume <br />to give aulhority lo violate or cancel lhe provision of any other stalo or local law regulating consiruction or lhe peAormance of <br />conslruction. That I am authorized by the own� r o( this property to peAorm Ihe work for which application is made and 1 comply with the <br />State Conlraclors Law_18.27 RCW and'Z�100 WAC. <br />U •��-o'} <br />