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PERMIT APPLICATION <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 />A'PLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />r ��r C���1��a__/_��v�- <br />LEGA LOT N0. V I <br />DESC. <br />BLOCK I TRACT <br />PARCEL TAX I.D. fl <br />lI —3D—�� <br />'�t6yT�/ � ') <br />'Y � il� n <br />....,._c� v� 1,�,�e I 1 kxl ll iti? � 8c�� \ � � .� ��o +�'�l `J>2f�3 �-I2� �5 � -�r'n �n <br />� C(� bt� i�� f'� � c <br />TENANTNAME I CONT TFORPERMIT PHONE <br />CONTR/1CTOR AD[rRESS . CITY2IP PHONE ZG(,> �'j2;.j� <br />r'i-c�ti i=Yx'rcJ��SvJS-ie�v� �3�c-1 �2c���:.�+at- i�v�-S :xc�tlt.:. v��,. �$ll3 '15SS <br />CONTR.UCENSEt__._ _ .�� <br />USE OF BUILDING <br />� <br />\ -t' ��c1C � �c �' i <br />WORK DESCRIPTION <br />( �� L _ l� -�-�, C�-L � <br />1�0.�--�w� ��'�-. <br />HEAT <br />CONTRACT PRICE OF WORK <br />_Eledric _Gas�,Other �� �) I�j�j��(� � <br />�-�C�..IvV�.(_��'L. �� .���L�'�='\X_AV�-'� ��`; <br />� 0 <br />N0. I T'PE OF FIXTURE OR ITEM <br />Dathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbarlmop/g <br />Urin01 <br />rloof <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />Forced air systems c1� <br />Gas piping -�CyY�'('� Ca..... v��,'rciD- <br />Water heater <br />Gas fireplace �.J�..� �W`��'�-�-'�--� <br />Gas 2nge <br />Clothes dryer S-� �7 ��,1� S <br />R h od <br />ange o <br />[xhaustfan <br />Heat pump <br />UnA healer <br />eoiter <br />Reirigeration <br />Woodstove <br />Other <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3706 <br />I hereby ceritify that I have read and examined this appiication and know the same to be true and conect. All provisions of laws and <br />ordinaces goveming this type ot work will be complied with whether spedfied herein or nol The gran6ng of a pertnit does nol presume <br />to give aulhoriry to viotate or cancel the provision of any other state or local law regulating construction or the perfortnance of <br />construdion. That 1 am authorized by the owner of this property to perform the work for which application is made and I comply wilh the <br />� St le Contradors Law 18.27 RCW and 296200 AC <br />_ �'� ,l _� n 1,'�r :E_.C� (�U ,`.. �� � �` \ (-a(r, <br />