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SITE ADDRESS <br />7��1 �� �i� <br />LEGAL LOT NO. <br />DESC. <br />PtRMIT APPLICATI(�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8R10 - FAX 425-257-8857 — www.everettwa.org <br />APPl1::ATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />L►✓, Q"7 <br />BLOCK TRACT <br />PARCEL TAX I.D. ti <br />PHONE <br />/ <br />L�,�n c.�c� C��-���Cr-� S�ll m��son� ST �i��- 9c x� ��zs-.>»-9a3U� <br />TENANTNAME CONTACTFOR PERMIT PHONE <br />4'Ac�t-n�T ,��nlr,4� I g��S'� �,4p��cil%f- Nz�-77����Ic�`i <br />CGNTRACTOR ADDRESS CITY2IP PHONE <br />p�, �-N,� 6���,n�»ti� �-Hr� irtiiy ��,�AtiY �ti' `v,�� yzs-��s-C�yl�l <br />CONTR. LICENSE # � �.j 7 <br />c.���;y nN c,�a,� �,,� <br />USE OF BUILDING � HEAT SOURCE I CONTRACT PRICE OF WORK <br />WORK /DESCRIPTION <br />/. E/'['/� f- L L K 1 ST 1� �' <br />N0. <br />[ L�C'�'IC'-- %G1J--�.'�i`��C <br />TYPE OF FI%TURE OR ITEM <br />Toilel <br />Balhlub <br />Lavalory (wash basin) <br />Showcr <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />laundry tray <br />Sink (servicelbaumop/etr..) <br />82ckfiow prevenler <br />Urinal <br />Drinking Foun�ain <br />Flnor drain <br />��rcasc Ira�� <br />Roo( drains <br />Other <br />� Electric __ Gas _ Other I � ���7��� �'�'� <br />DlL G.J�"'n-'A-cE 6l/�� N��ti-' <br />MECHANICAL <br />NO. I TVPE OF FIXTURE OR ITEM <br />A/C — air handlinc� unils <br />= Forced air systems <br />Gas piping <br />Water heater <br />Gas (ireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Retrigeration <br />Woodstove <br />Other <br />CIN OF EVEREP' LOCAL SALES TAX CODE IS �105 <br />I hereby ceritify that I have read and examined Ihis .ipplication and know the same to be true and correcL All provisions of laws and <br />ordinaces goveminq this lype of work will be complied with whether speci(iod herein or not. The c�ranling o( a permit does not presume <br />lo �ive aulhority lo violate or cancel the provision of any �thor slatr. or local law regulating constr�ction or the perfnrmance of <br />conslruclion. Thal I zm authorized t>y Ihe owner o( this property lo pedorm the work (or which app�icalion is ciade and I comply with iho <br />Slale Conlrac rs Law 18.2? RC�W and 296. AC. <br />� .-,,.�.r,, �/! ._�'�' ; °�-/l-C%c, <br />