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PEr�MIT APPLICATIG�J <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />�32 3 E� <br />LEGAL LOT NO. <br />DESC. �I <br />� <br />TRACT <br />PARCEL TAX I.D. # <br />PER�91T # <br />Mo4�i <br />KJA���f I-��A-ck- I�l�'L°� l���nt 1��0 L��1.No��WA �-/2� 23Z-� <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />N1� � ti I�Au �� I�,�,�A-�l�- y ZS -3 53 -� 2 2 � <br />CONTRACTOR��..1M�q P�,,,�,h;,./q AODRESS <br />n d <br />CONTR. LICENSE ���J M I� � 1' ����� �� <br />USE OF GUILDING <br />WORK �ESCRIPTION <br />�Vn1 L�.�.S <br />U <br />L�ue <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />5ink (service/badmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />I — HEATSOURCE <br />Electric �U Gas Other <br />-t � t N S � � �j— <br />NO. I <br />CITYIZIP PHONE <br />�1��►�o���A 36v - `7°��l - 3 �j� <br />CONTRACT PRICE OF WORK <br />�U'O�� — �UUpOo <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Urit heater <br />9oiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERE'f7 LOCAL SALES TAX CODE IS 3105 <br />! I hereby ceritify that I have read and examined lhis application and know the same tn be true and correct. All provisions of laws and <br />� ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />' to give authonry to violate or cancel the provision of any olner state or local law regulating construction or the performance of <br />I constructi n. That I am authorized by the owner of this property to perform :he work for which appllcation is made and I comply wilh the <br />i State / tractor�w - 8.27.RCW �d 29 00 WAC. y <br />� /n/ '�� � %�l'h � !/ ' Z -D <br />