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��v,� <br />LEGAL LOTNO. <br />DESC. � <br />OWNER <br />;f}��i,l./Y�� � <br />TENANTNAME <br />\ <br />l �> � <br />CO ACTO � <br />� <br />CONTR. LICENSE # <br />3 <br />USE OF BUIL�ING <br />,' <br />pERIMIT APPLICATION <br />CI�"Y 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 APA TO 4 PM <br />FAflCEL TAX I.D. # <br />LOCK I� TRACT OR SUBOIVISION p <br />CONTACT FOR PERMIT <br />� �. � <br />N�LGvI s�'Lg ^V 7�IbO 7-ftiitt�%JCv�P[I <br />� �/�7� �U <br />HEATSOURCE <br />_. Electiic __ Gas _ Gther <br />T# <br />G7� � <br />PHONE yZs-7��P��-3S <br />PHONt /�lQli'l Si �"�f,j. CC% <br />�.Z � %%Lo�. c�,� �I <br />CONTRACT PRICE OF WORK <br />� / 4,��,-'� <br />WORK DESCRIPTION � <br />��nS�c�! -�- �-�- 6�, �-d' ��}-f� �v�4u,��/ L,G�i�n�z!' Le�k.�.� <br />NO. ` TYPE UF FIXTURE OR ITCM <br />Toile� <br />Bathtuh <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposa� <br />Dishwasher <br />Clothes washer <br />Water tsater <br />Sink (servicelbar/mop/etc.) <br />Backllow preven�er <br />Urinal <br />Drinking Foun�ain <br />Floor drain <br />Grease trap <br />Roof drains <br />O�her <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />NC - air handling units <br />Forcad air systems <br />Gas piping <br />W ater hea�er <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Relric�eration <br />W oodstove <br />Otner___ __ <br />CITY OF CVERETT LOCAL SALES TP�( COOE IS 3705 <br />I hereby ceriti(y Ihat I have read and examined this application and kno�v the same to be true and correcL All provisions of 12ws and <br />ord��aces governing lhis type of work �vi�� be compli�d with wheiher specified hercin or not. The granting ot a permil does not presume <br />to c�ive aulhoriry to vi�late or cancel the provision of any other state or lacal law regulating construction or ihe performance ol <br />conslruction. Tl�at I am authorized by the owner of this property to �.erform ihe work for which applic .don is made ana I comply wilh thr. <br />Stale ('ontractors Law 1827 RCW and 296.200 WAC. <br />�./� F'�l //�' // / ,.�'r �-t` /�J �� <br />l/Z <br />