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SITE ADDRESS <br />�!v �i0� N. <br />LEGA LOi NO. <br />PCRMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />ppCVIDEhiCE E�tEi�C-Y'r <br />/v�bIGAL GEhi1'E1C <br />TENANTNAME <br />P�'o1 ti�1�10E. ElER�iT <br />h�tEt��c.A.L C.Et�Ct"ER <br />CONTRACTOR <br />KIizI'L�Y COLE PFS'X1"i�QfE.S <br />CONTR. LICENSE # <br />1�1'�-TLGA 2-72RF' <br />USE OF BUILDING <br />o� u� <br />��� o'_c1�SaAt�1cY <br />PARCEL TAX I.D. p <br />2�105��0�2,4 <br />TRACT <br />�1lo f�pG1�IG AYEhIUE <br />p.0. �.,OX 106-7 <br />I CONTACT FOR PERMIT <br />b�Y u-! yAY�� <br />6VEf�T7� <br />ADDRESS ��n'2�P <br />1010 5E EYE-�ZES'r lvWLL WAY <br />SU17'E 1�2, EYEj�`T'f'�YdA °)Sil�B <br />HEATSOURCE <br />_ Electric 1C Gas _ Olher <br />� - �2-�5 <br />PERMIT N <br />� >9�5� <br />PNONE <br />258 -'l 123 <br />PHONE <br />425 � 25�J • OB�o a <br />PHONE <br />425 • 2<o I • 4��J2 <br />CONTRACT PRICE OF WORK <br />� I, Gbo, DOO. DD <br />WORK DESCRIPTION <br />�t��ll o� Exl�t�t�-IC.E �iECL �S'�.E i"-� E-lcw at--��cc-s, �� <br />THE GXISiII-iG� �Ullx7lNf� IS A ot-!E �st"'b42f �UIl�71t-lGt . <br />N0. I TYPE OF FIXTURE OR ITEM <br />7oilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/bar/moplelc.) <br />Back(low preventer <br />lJrinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other _ _ <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />�orced air syslems <br />Gas piping <br />Water heater <br />Gas fireplaco <br />Gas rango <br />Clothes drycr <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby cerili(y thal I have read and examined lhis applicalion and know the same lo be true and correcL All provisions of laws and <br />ordinaces govemin� Ihis rype of work will be complied with whether s�ecified herein or noL The grenting o( a permit does not presume <br />lo givo authority lo violale or cancel the provision of any olher slate or local law regulating construclion or the performance of <br />conslruction. That 1 am aulhorized by lhe owner of this propedy to perform Ihe work (or which application is made and I comply with lhe <br />Slate Conlractors Law 18�2,7 RCW and�,96.200 WAC. <br />°�-26-dG� <br />�L <br />