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P�`RM�T APPLICATIG.J <br />CITY OF EVERETT PERMIT SERVICES �� <br />3200 C�DAR STREET, EVERETT, WA 9820 � 1.I,�I'�i� <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />� .e�z,� W i� <br />LOT NO. BLOCK <br />�c�vc��C,-�e,� yc,ha� <br />TENANT NAME <br />lGbell � ►�U�Lr- <br />C NTRACTOR `���I��'-��U�til <br />���� <br />CONTR. LICENSE # <br />h`!'1 I I•? s <br />USE OF BUILDING <br />PARCEL TAX I.D. # <br />SOS/��� <br />TRACT OR SUBDIVISION # <br />PERMII <br />�� <br />I" <br />� ��—��D� <br />PHONEr9 E;J �7 'QS�I <br />�� <br />AUDRESS CITYRIP PHUNE <br />r 733i li�fe,'(a,�z r�v� �� �\��`��.�,w ��>ia 9fi3� <br />HEAT <br />_ Eleclric _ Gas _ Olher <br />CONTRACT PRICE OF WORK <br />� !'SU0 , o J <br />WORK DESCRIPTION y� n � �J f� ' � �i /J /�/,�% <br />U��YV�a�L�.P S�N C��-sbl� /�,2�6"� � ��L�// 1�� <br />� / L / f— <br />� �.ti(� .�.. � //�--/ .. J � % ��,L> C�'Itr ��. <br />l a- . � I/ Q �P � <br />:G7 <br />PLUM <br />TYPE OF FIXTUR[ OR ITEM <br />Toilel <br />Dalhlub <br />Lavalory (wash basin) <br />Shower <br />Ki(chen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />Dack(low prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Greaso trap <br />Roof drains !"� <br />Olher _ ��'�n u � ���'`i,tV <br />�� <br />N0. <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air syslems <br />Gas pipinc� <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Rangohood <br />Exhaust (an <br />Heal pump <br />Unil heater <br />Boiler <br />Re(rigeralion <br />Woodslove <br />CITY :�F EVERETf LOCAL SALES TAX CODE IS J105 <br />I hereby ceri�ify thal I have read and examined lhis aoplica!ion and know lhe same lo bo truo and correcl. All provisions of laws and <br />ordinaces c�overning lhis type of work will be complied wilh whether specified herein or not. The c�ranling of a permil does not presume <br />to give authority to violate or cance� lhe provision of any olher state or local law regulating consWction or the performance of <br />conslruclion. That�l am aulhorized by �he owner of �his properly lo perform the work for which applicalion is made and I comply wilh lhe <br />Stale Conlraclor$ Law 1o.27 RCW and 296.200 WAC. <br />� . . �.. _ //%l� — c�% <br />� <br />