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SITE ADDRESS <br />�So� <br />LEGA LOT NO. <br />TENANTNAME <br />P�RMIT APPLICATION <br />CITY �F EVERETT PERMIT SERVICES <br />3200 CEDAR STRF_ET, EVERElT, WA 982�r1 <br />425-257-8610 - FAX 425-257-8857 - www.everettw�a.�rg <br />APPLICAT�ONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEI TAX I.D. A <br />A/JC �E�s��s �— �,o a , PD�- o� <br />BLOCK TRACT � <br />G � �IA,'� l�v,Zsf .D�iii�in�1 i <br />Ctro�va r o,u <br />CONTR. LICENSE fls, � <br />- - Ci <br />USE OF BUILDING <br />m tr <br />CONTACT FOR PERMIT <br />S�D%s��R <br />3 be --75%- ��{.�D <br />ADDRESS� zc� LS�-/��4 <br />HEAT SOUF <br />�� EleGric Gas <br />WORK DESCRIPTION <br />l�c r�� �'' �T,��2S <br />NO. I TYPE OF FI.YNRE OR ITEM <br />Toilel <br />6athtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbadmop/etc.) <br />BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />PERMIL�%/ y - �/� <br />,«�`-' � <br />�,r�/J�c o�Poi� j � <br />�- % tx�d� <br />! <br />%Aio'/�t /D� � <br />c a <br />��i7C r. nA DS d �' <br />�ITY21P PHONEl1�9S�i�'f <br />��'� �fa-7sr-�y� <br />3���-y2� -zss3 <br />CONTRACT PRICE OF WORK <br />Other �Q� e00 <br />���z I�o� <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas pipin� <br />Water healer <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby ceritify that I have read and examined this applicalion and know lhe same to be truo and correct. All provisions of laws and <br />ordinaces governing this lypo of work will be complied wilh whether specified horein or not. The granting of a permit does not presume <br />to give authorily lo violate or cancel the provision ot any olher slato or local law reyulaling construction or the performance o( <br />construcfion. That I am authorized by lhe owner of ihis property lo perform lhe work for which application is made and I comply with the <br />Slale Conlractors Law 18.27 RCW and 296.200 WAC. <br />J ` __L�,�� �' 2� �5— <br />Si�nature of Own dCon actodAuthorize Agent p te �I� <br />