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PERMIT APPLlCATION <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 />SITE ADDRESS <br />LEGA� LOT NO. <br />DESC. �—��2 �� <br />OWNER <br />C� 1�.,,, b;� C� �d� � <br />TENANTNAME <br />We.Sl,fi W�-kHN:S <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />�s'-1 �80507UO3o6700 <br />BLOCK/ TRACT O(R� SUBDIVISION # <br />L_/ D__ ., r-L ) 1✓.o M..--% _— <br />C��rry /u:oN SrJn vr��fe�•�s <br />CONTR. LICENSE tl <br />(3L=RRyNCfd77GA1 <br />USE OF BUILDING <br />CoN, n� erc � �. <br />PERMIT# <br />�o. 3�,� �os.3o �H i4„�o,,,o, TX '7��79-os� <br />ICONTACT FOR PERMIT <br />Cl,ris��p4er E�ris-f <br />'7 L�W <br />WORKDESCRIPTION —��S�aII ��� O�ne <br />/��f�.^5 ,,.,ti, lc.Jo. {'1�51. Mav.a�c?� <br />NO. I TYPE OF FIXTURE OR ITE�7 <br />� Toilet <br />8alhlub <br />Lavalory (w=.sh basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (servicerbanmop�etc.) <br />Backtlow preventer <br />Urinal <br />Drinking Founlain <br />Floor dram <br />Grease Irap <br />Rool drains <br />Olher _ _ _ <br />0 � <br />HEAT SOURCE <br />_ Electric _ Gas _ Olher <br />�5J77G -$S35 <br />��ix�r i�o.asi�as.ce <br />, <br />�c.�'-t�ii'� W�1 <br />(Yz�) <br />48'�O,j —.j flYD <br />776 -5�35 <br />CONTRACT PRICE OF WORK <br />� �� �a5�'' <br />se-f- o� GED-iflv„�.,i.,a�e�1 �;�c��u;�iw.( eGcz.��te� <br />fo w�,�l� <br />NO. I TYPE OF F�XTURE OH ITEM <br />A/C - air handling ur,ds <br />Forced air system� <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I heieby ceritily Ihat I have read and eramined �his application and know the same to be lrue and correct. All provisions of laws and <br />ordinaces goveming �his rype of work will be complied K�ilh whelher specified herein or noL The granling of a permil does not presume <br />to give authoriry to violate or cancel the provision of any other state or local law regulating conslruclion or �he peAormance ot <br />consiruclion. That I am authorized by the owner of ihis property to perform �he work for which application is made and I comply wilh �he <br />State Coniractors �aw 18.27 RCW a 296.200 WAC. <br />/'�,..t �,.r,e�. � h,c �� � �'l �<< � �-r90 8 <br />'/2 <br />