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SITE ADDRESS <br />"'�3Z T3�ve� <br />LEGAI lOT NO. <br />DESC. I <br />1 <br />OWNER <br />L3Fl�jJT GQ�=G <br />MEfq2 F � - <br />TENANTNAME <br />N//-� <br />PERMIT APPLICATIOt� <br />CITY OF EVERETT PERMIT SERVI��ES <br />3200 CEDAR STREET, EVFRETT, 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.D. # <br />ni� t�3�r3�0• <br />BLOCK TRACT OR SUBDIVISION # <br />CONTR. LICENSE p D�NE�- <br />IiSE OF BUIL�ING <br />�. <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTl1RE OR :TEM <br />Toilel <br />6athtub <br />L2vator� (wash b:isin) <br />Shower <br />Kilchen sink 8 disposal <br />Uishw.r.�.her <br />Clothes washcr <br />Waler healer <br />Sink (s�rvice�barlmop'etc.) <br />E3ackfluw preventcr <br />Unnal <br />Drinkinp Founlain <br />Flonr drain <br />Grcase Uap <br />Rool c�rains <br />Other -. -- _- -- <br />CONTA':T FOR PERMIT <br />GeEG Oc,��n�s <br />�A06F2�€SS <br />HEATSOURCE <br />� Glectric _ Gas _ Other <br />P8�6—� <br />�� p_o8 <br />PERMIT # <br />I� 68( <br />'gLOS yL5- S7Y'�oT3G <br />PHONE !�ES-3Y7� (oYs6 <br />E•MAIL �tge�.PA� WEqSQ6�n�,� <br />P-Fa0' <br />CONTRACT PRICE OF WORK <br />�p�/��e �,vic.=CL�Ii-`�_ <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />NC - air handling units <br />ForceA air syslems <br />Gas piping <br />1'Jater he�,ter <br />Gas fireplacc <br />Gas range <br />Glolhes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boi�er <br />Refrigeralion <br />Woodslove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby cooli(y thal I have read and examined ihis application and know tho same to be irue and correct. All provisions of Iaws and <br />crdinaces goveming this rype ul �sork will be complied wiih :�hether specilied herein or noL The c�ranling of a permil does nol presume <br />lo qive aulhorily lo viola�r or canr,el Ihe provision o( any other s:hte or local law regulatiny conslruction or tl�o performance of <br />construclion. 1 tial I am , uthorized by the o�vner of this property to pc�tonn Ihe work for which application is made and I comply with the <br />Sla�e Con�ractors Law te �, 2C\N and 29fi2004NAC. <br />