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SITE ADDRESS <br />7,� S �V� <br />LEGA LOT NO. <br />DESC. <br />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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ARCEL TAX I.D. # <br />r�� �- DSD�vo <br />�LOCK TRACT OR SUB�IVISION # <br />SEc o-t TwP a� RG <br />vrrn�n <br />CacumgsA ��C�'1� <br />TENANT NAlAE <br />I3�U L�7S <br />CONTRACTOR �n G��� STn / Co, <br />.�� <br />CONTR. UCENSE #`ry� Gi/.� C L 4�' <br />� 1 l� <br />USE OF BUILDING <br />��T/�} ZL <br />r, •� <br />OS <br />�. �[, c f�J �� 9� <br />ICONTACT FOR PERM:T <br />3/C�4+� LAwse.�! <br />/j'� �1�, Ynf$T/7;� G'U. <br />ERMIJ <br />�'� ;�`c�� - U <br />I oF g5 <br />v .�,¢„► lM(7�v� �x <br />PHONE '/S� � Fjj�— ��S,I <br />7 <br />a�ru.d�eM� <br />....,��..,, _...._.. . - <br />S�S'-3"OAVE, S, ��•7��-33/1 <br />� SE,4TlC� 4�?► 3c/ <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />�Electric _ Gas _ Other �p'� � � J� r <br />WORK DESCRIPTION �', /C, �!1 L C T�o (a) <br />-�-,� ��r <br />REc��-t� a�E G ) <br />NO. I NPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking �ountain <br />F!oor drain <br />Grease trep <br />Roof drains <br />Other <br />n��w Ti�IE S'T f�T �u�FS, <br />.�L�c��t�. Gs'�tl�7 �7.�- <br />N0. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausl fan <br />� Heat pump <br />� Uni: heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritily that I have read and examined this 2pplication and know the same to be true and correct All provisions of laws and <br />ordinaces goveming ihis lype ot work will be r.omplicd with whether specified herein or not. The granting ol a permil does nol presume <br />to c�ive authoriry to violate or cancel the provision of any olher state or local law regulating constmction or ihe pedormance of <br />construction. That I am aulhorized by the owner ot this property ro perlorm the work for which application is made and I comply with the <br />State Contrac�or,� Law 1827 RCW andz95.209 WAC. <br />`/Z <br />�$1)q <br />