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SITE ADDRESS <br />%`�' Z C �3c'�'� <br />LEGAL LOT NO.1' <br />DESC.� � 'L'�� � <br />TENANT <br />P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERCTT, WA 98201 S_ D1 ...06 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM `�-i �-�� `' � <br />PARCEL TAX I.D. # <br />(9r�e ���5`jg7Q��CVZ2�� <br />BLOCK TRACT <br />1 <br />�� L'�G�C6'C <br />CONTACT FOR PEa <br />PHONE <br />J <br />� , � `.:�c1! C t �f t . � ..Ij. ;_" <br />r;`)'%�t'L� � <br />CONTRACTOR y II.� AD�RESS CITYRIP PHONE <br />�'LHll�l,'✓�"l tYJ��li�j <br />� .i, . <br />CONTR. LICENSE N � � - • ' �� �' � �� <br />i'��]t-�HDy7vr,��'>.��! i << - <br />USE OF BUILDING <br />�� �i� <br />WORK DESCRIPTION <br />j,�? i�> <br />HEATSOURCE <br />_ cleciric �', Gas _ Olher <br />������{ r.�����`Cy�✓E�ir-� ll:o <br />���U <br />NO. � TYPE OF FIXTURE OR ITEM <br />�_ <br />i <br />� <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Wa�cn c�ater <br />Sink (service/badmop/etc.) <br />Backllow preventer <br />Urinal <br />Drinkinc� Founlain <br />Floor drain <br />Grease trap <br />C.00f drains <br />Other <br />CONTRACT PRICE OF 1YORK <br />o �^ <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas pipinc� <br />Wat�r healcr <br />Gas fireplace. <br />Gas rango <br />Clolhes dryer <br />Range h;,od <br />Exhausl fan ; - � <br />Heat pump <br />Unit heater <br />Boiler <br />Rofrigeration <br />Woodslove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerility that I have read and examined this application and know Ihe same to bo true and wrrecL All provisions o` laws and <br />ordinaces goveming this type of work will bo complied with whether specified herein or nol. Tho granling of a permit does not presume <br />to give aulhority to viqlale or cancei ihe provision of any other stale or �ocal law regulating consiruction or lhe pedormance of <br />construclion. Tha am author' d by the owner of this property to peAorm Iho work for which applicalion is made and I wmply with Ihe <br />Slate Conl�c s Lay✓(8: CW and 29fi.200 WAC. ^ <br />SEb %7�S ��� <br />