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�.. <br />PERMIT APPLICATION <br />CITY OF �VERETT PERMIT SER�/ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.crg <br />SITE ADDRESS <br />��Z ��Uer � <br />LEGAL LOT N0. <br />D[SC. <br />OWNER <br />3e�,,r `��_� <br />N� fr � fls�er�S <br />TENANTNAME <br />N/F}- <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TU 4 PM <br />PARCEL TAX I.D. # <br />,�� (�'343�0•�n� <br />BLOCK I TRACT OR SUBDIVISION p <br />CONTR. LICEN�,E # ��N �� <br />USE OF BUILDING <br />!�� �, bu <br />WORK DESCRIPTION <br />�. RcPlacc 5riis <br />i• kD0 5' x y� <br />76: <br />CONTACTFORPERMIT <br />s <br />HEATSOURCE <br />� Eler,tric _ Gas _ O�her <br />t �'les� ;� bed�oeu�t u�; sc.FFts <br />� joµ{y( WEST COI?NLcR <br />7 �/O -D� <br />!MJ # <br />��J -�� <br />'$Lo5 7LD- JT/' �oT <br />PHONE Y� f'3yj• ��6 <br />CONTRACT PRICE OF WORK <br />3. ADD SNED Th�%NtEK Tv w6ST 5/�E � gEDRooM �$Ay�f� �117Sf. ± <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilel t � <br />BalhWb ; ! <br />Lavalory (wash basin) ' / <br />Shower <br />Kilchen sink & dispcsal <br />Dishwasher <br />Clolhes washa <br />W aler healer <br />Sink (service/barlmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease t�ap <br />Rool drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace ' <br />Gas range <br />Ciothes dryer � <br />Rangehood <br />Exhausl(an /� i <br />Heal pump <br />Unil healer <br />Boile� <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 9705 <br />I hereby ceritify that I have read and ezamined this application and know the same lo be lrue and wrrect. All provisions of laws and <br />ordinaces goveming O�is lype ol work will Le complied with whe,her spec7ied herein or not. The yranting of a permil does not presume <br />to give aulhoriry lo violate or cancd the provision of any olhPr siale or local law regulaling r,onsiruction or lhe performance ol <br />conslruclion. Thal I am aulhorizeA by lhe owner of this property lo per'orm tho work (or wh�ch apphcalion is made and I comply �vilh Ihe <br />Stale Cr,nlreclors La�v L$.ZZRCVJ and 29G.200 �VAC. <br />� <br />L------- <br />��'L <br />