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SITE <br />LOT tl0. <br />P�RMIT APPLICAiI �N <br />CITY OF EVERETT PERMIT SERVICES <br />32f 0 CEDAR STREET, EVERETT, WA 98201 <br />425-25i-8810 — FAX 425-�57-8857 — www.everettwa.org <br />ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREOIT CARCS ARE NOT ACCEPTED <br />�✓�EtT �-( Co/�l✓tnf GL� <br />TENANTNAME <br />5 ��l V�c,�E <br />CONTRACTOR �/���p�f� SI6� C <br />CONTR.LICENSE� ,�,��os�o3i►�3 <br />USE OF BUILD:NG <br />l�F1/�1 L /car�hlEltG1�'t <br />PARCEL TAX I.D. # <br />2g0/r07d03d7000 <br />TRACT <br /># <br />/>S 71�i�0 � ,✓tra�yr.�K�,✓�/ /ao17 /-P��-y42-I <br />CONTl.CT FOR PERMIT PHONE <br />S�C✓f �d�2�rn/ (2e6� Z82-07d0 <br />A�DRESS <br />�Zss �tri�l�,�f ,✓ <br />HEATSOURCE <br />Electric _ G2s _ Other <br />CITY2IP <br />s��f�� <br />f $/0 i <br />WORK DESCRIPTION <br />l N5 ���1. dr/f S�,✓6cf F�E I u�w�'i✓9f�0 W%f tit- f I6nl. <br />NO. � 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 />Sink (service/bar/mop/eic.) <br />Backflow preventer <br />Urinal <br />Drinking Fo�ntain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />�,6% z�vor�a <br />TRACT PRICE OF WORK <br />�S�GD -� <br />NO. I TYPE OF FIXTURE 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 />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SAI.ES TAX CODE IS 3105 <br />I hereby ceritify hat I hav : read and ezamined lhis application and know the same to be true and correct. All provisiuns of laws and <br />ordinaces gov ing thi ype of work wili be complied witn whether specified herein or not. The granting of a permit does not presume <br />to give authorit to viol t: or cancel lhe provision of any cther state or local law regulating construction or the performance of <br />construction. T at I a thorized by the owner of this property to perfor.m the work for which application is made and I comply with the <br />Slate Ccntracl s La 1 i.27iftCW and 296.200 WAC. <br />S' 'd � <br />Date /`� <br />Y` <br />