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,- <br />PERNIIT 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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />C�-��o�sy A�Nu� <br />LEGAL LOT NO. BLOCK <br />DESC. Z�}' 'f'ZG% �� <br />1�A-uro � G-WfLco77b 2o6�.SS <br />T(E�NANTNAME <br />�7'G(i' i�'�O�%F► <br />CONTRACTOR ./IM y;� <br />rz .► <br />CONTR. LICENSE # <br />PARCEL TAX I.D. # <br />�`f968(?�ZB� <br />TRACT <br />L�Glo�e �.¢ek- •4-�D <br />: r <br />PERMIT # <br />b� Ca'a3Y �-I/� . �C�ILeI�" �?1� • 339 Za <br />CONTACT FOR PE MIT PHONE <br />ow�t�-�-�w�. fi��s 4�.3s9.1��z <br />(�� ADDRE55 CITY2IP PHONE <br />� /°o $ox �SD � rv1,��sviu-�tv/} igzn7� 3k�o-658-8533 <br />� <br />USE OF BUILDING <br />�.s�D�r'r�A-L- �Sr�� <br />WORK DESCRIPTION <br />NO. I TYPE OF FI%TURE OR ITEM <br />Toilel <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Orinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />� <br />HEATSOURCE <br />Electric � Gas _ Other <br />1f1G2$'f.P�c S�p.�1^fL <br />CONTRACT PRICE OF WORK <br />���7,1fS3 <br />/Ha5 �E.Y <br />NO. I TYPE OF FIXTURE OR ITEM <br />NC — air handling units <br />Forced air systems <br />Gas piping <br />Water hea�er <br />Gas (ireplace <br />Gas range <br />Cbthes dryer <br />Ran�e hood <br />� Er.haustfan <br />Heat pump <br />Unit healer <br />f3oiler <br />=Refrigeration j <br />Woodstove �/ <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3705 <br />I hereby cerilify that I havo read and examined lhis application and know the same lo be true and correct. All provisions of laws and <br />ordinaces governing this lypo ol work will be complied wilh whether specifed herein or not. The granting of a permit does nol presume <br />to give aulhority to violate or cancel lhe provision of any other state or local law regulaling consWctlon or the pedormance of <br />construclion. That I am aulhorized by the owner of this property to peAorm the work for which applicalion is made and I comply with the <br />State Contrectors Law 18.27 RCW and 296.200 WAC. <br />ll , �J /J � _ n ,. . _ <br />�Z <br />