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�-- <br />PERMIT APPLICATI4N <br />CITY OF EVERETT PERMIT SERVICES <br />'s200 CEDAR STREEf, EVERETT, WA 98201 <br />42�-257-8810 - FAX 425-257-8857 - www.everetriva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />�ao2 SE F_�Et�r:�nnfy,c. <br />WTNO. � BLOCK � TRAC7 <br />PARCEL TAX I.D. A <br />i U �l 4S UU�fI <br />CWNE.q ADDRESS cITYrz1Y rrxJl'1e (({40.> G) Z— <br />�1 Nr>l.�)Po/LT <br />Sry„rpFp�$r C.o. g'343 V�N LU�ILM/�N A�.��. 3� 9Ecxu-��� q7.(.Go ` 0'too <br />TFNANT NAME CONTACT FOR PERMfT PH�ME <br />Sr�,�; +��-r�2ys I w�w�r�.. Q. L3�o)3ze �3�� x,bz <br />CON7RACTORUT� g6 On,o✓�oco,^ ADORE55 <br />CONTR. LICENSE # <br />USE OF BUILDING <br />M�iLca-'T� c. G <br />HEATSOURCE <br />y Elactric _ Gas _ Other <br />CfTYlLP PHONE <br />CONTRACT PRICE OF VYORK <br />"j:p v J <br />WORK DESCRIP'TION <br />InJf�p�lUrl,/kt�i CnxT�.�rJ 'FOrL. SrEVE +- rSfKLn-Y$ R-ErR+'i��"Ort8 <br />NO. I TYPE OF FlXTURE OR ITEM <br />Tdiet <br />BathWb <br />Lavatory (wash basin) <br />Showe: <br />Kihhen sink 8 dspos.9 <br />pishwasher <br />Cbthes washer <br />Laundy tray <br />Sink (servicelbar/mopletc.) <br />BacfQlow preventer <br />Urinal <br />prinldng Founhaln <br />Floor �zin <br />Grease trap <br />Roof drains <br />Other <br />NO. I i TYPE OF FlXTURE OR ITEM <br />✓ A/C - air handling unils <br />Forced a(r systems <br />Gas piping <br />Water heater - �—� <br />_ Gas fireplace j ,-' ... I <br />Gas range � <br />— Clothes dryer !� / � j � <br />� Range hood i <br />_ F�haust tan � ��t <br />_ Heatpump <br />_ Unit healer ��\ <br />_ Boller �/" <br />_ Re(rigereUon <br />CfTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritiry Ihet I hava read and ezemined ihis oppiication end know the same to be We and correct All provisions of Iaws and <br />adnaces goveming this type of work w� be complied wRh whether specfied herein or not The ganting ot a pemiit does not presume <br />W g'rve authority to violate a cancd the provision of any other state or {ocal law regulating cortstruction or ihe performance ot <br />constn�on. That I am author¢ed by 1he owner of tfiis property to peRorm the work for which application is made and I cortply with the <br />State Contractore law 18.27 RCW and 296.200 WAC. ��,,,,v.i�ln.cyua3,d.� � r}� -(eti�.rr ! W�rn�w•n- <br />