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P�r�MlT /O�PLI�ATIC��� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERFTT, WA 98201 <br />425-257-fi810 — FAX 425-257-8857 — www.evereftw�.ora <br />APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM y_ ��_p <br />SITE ADDRESS . <br />�y 00 �ve �5�een <br />LEGAL LOT NO. BLOCK <br />DESC. <br />OWNER <br />TENANTNAME <br />S Pl' L I Llil �(�7R1 C i j �� <br />CON'fRACTOR [%�� Vu ✓1CCl�� ��✓'L <br />i� <br />PARCEL TAX I.D. # <br />�O 5ci7��C <br />CONTACT FOR PERMIT <br />D��,✓ �t�e��cs��-� <br />ADORESS/ <br />�t��.,� Yf�'(�cicv f)- <br />cuN�a.uc�msea�c(vt�,�-{p0�77�'/J ;� /U/Z 1�.✓,5' ST <br />USE OF BUILDING <br />WORK DESCRIPTION <br />��Srcc(� c�v✓i <br />v <br />p�'ik�- s���y <br />NO. � TYPE OF FIXTURE OR ITEPA <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/barlmopletc.) <br />Backflov� preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />P RMIT # <br />6� ' 7���� <br />:ITYIZIP PHONE <br />• tiONE <br />5y!- �S2 -ZZS�Y�SY/-.2T�_ � <br />CITYILP PHONE <br />L P�v_'s7�n �f' 3.Si-}i' <br />la: v�c �/�J Ci2 �73SJ s y�_ 7s?-LZ <br />Electric _, Gas _ Other <br />C �U',-N i �'�-C� <br />� �'I G �Ll . <br />CONTRACT PRICE OF WORK <br />� =3oUD -- <br />/� i <br />ijt y� -(</�j�ii„JS i J�t J yJ rP.-�7 �,-� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forc�d air systems <br />Gas piping <br />Water heater <br />Gas ffreplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust tan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove - <br />� Other rF Su p%e��lr.� j <br />S� Si 17'7 di (h . i t� <br />CITY OF tVERETT LOCAL SALES TAX CODE IS 9105 <br />I hereby ceritify that I have read and examined this application and know the same ;o be true and correct. All provisions of laws and <br />ordinaces governing this type cf work will be complied with whelher specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancei the provision of any other statr or local law regulating construc6on or ihe performance of <br />consiruction. That I am authorized by fhe owner of this property to periorm the work for whicti application is made ane�' comply with the <br />State Contra ors Law 1827 RCW and 296200 WAC. <br />� i // <br />iviGCf ;'f LG'ii'7�'��l�l 7/�/(%I <br />