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SITE ADDRESS <br />90� �� <br />LEGAL LOTNO. <br />DESC. <br />FcRMIT APPLICATIVN <br />CITY OF EVERETT PERMIT SERVICES <br />�200 CEDAR STRFET, EVERETT, WA 98201 <br />425-257-8810 — FAX A25-�57-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TRACT <br />�;i'a�. 13�- <br />�ARCEL TAX I.D. ii <br />�vere.�" <br />p �ay..od <br />PERMIT # <br />VI l� � D - <br />TENANTNAME CONTACTFORPERMIT PHONE ��3�� <br />�1�Ut�i y�LL� $�1 )%1 � �\Ke. `i1V�SbN C��� %� 1 —3t�C.D <br />CONTRACTOR ��,AV.�oN G' v C.OrFar�GP�ADDRE7�3 / A. YrO�'1 �� CI at,;i� W� �3(O� %j,i ;36� <br />b !�1 <br />CONTR. LICENSE p hs� M o a c_ o`� KA ���" ~_ D� ��� <br />USE OF BUILDIN3 <br />A��;�w� s��;u <br />WORK DESCRIPTION <br />HEATSOURCE <br />p.�� S J Eleclric _ Gas _ Other <br />oc� � c.a 1— b2eco�S -- <br />5 i1��.,� �ahhec� �vG�'�r� <br />NO. I TYPE OF FIXTURE OR ITEM <br />lailel <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kitclien sink & disposal <br />Dishwasher <br />Clothes washer <br />�Naler healer <br />Sink (service/bar/mopietc.) <br />Backllow prevr nler <br />Urinal <br />Drinking Founlain <br />Floor drein <br />Grease trap <br />Roof drains <br />Olher <br />CONTRACT PRICE OF WORK <br />�(S �C�O.oO <br />A�� g�,l��;� o= <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handlio� urits <br />Forced air systems <br />Gas piping <br />1Nater heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exliaust fan <br />Heat pump <br />Unit healer <br />�oiler <br />Re(rigeration <br />Woodslove <br />Olher <br />� <br />CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerili(y that I have read and examined this appiication and know the same to be true and correct. All provisions of laws and <br />ordinaces governing lhis lype of work will be complied wilh whelher specified herein or noL The granting of a permit does not presume <br />to give aulherity to violale or cancel lhe provision of any other state or local law regulaling construclion or the performance o( <br />conslruction. That I am authorized by lhe owner o( lhis propeAy to perform the work tor which application is made and I comply with the <br />Slale Conlrectors Law 18.27 RCW and 296200 WAC. � � <br />�/Z <br />