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, �a� _ U <br />LEGAL LGTNO. <br />D[SC. <br />OWNER S � � <br />�f %�ql'f /�G� <br />TENANTNAME <br />�v,bw�1 <br />iRACT RCt ¢ <br />CONTR. LICENSE # <br />USE OF BUILDING <br />PCRMIT APPLICATI�UN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APFLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�4LL <br />BLOCK <br />Co rjv-��cl� na� <br />m ra,Q�c_� �L <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION # <br />ADDRESS <br />y�Z. � Ut�'2TT1n0.U- <br />(CONTACT FOR PERMIT <br />K-21� i � Cor� c� <br />ADD <br />HEATSOURCE <br />PHONE <br />JV\0.�Suf1\�' <br />`'' � 98J.71 <br />�Electric _ Gas _ Olher <br />S� <br />«J r'_JG�� � = <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/badmop/elc J <br />BackFlow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />- 3.5" �-0 <br />�"1'W�� <br />�-S 2�3 � � Z�j <br />�-{2S 295 GG2q <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clolhes 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 SALES TAX CODE IS 3105 <br />I hereby ceritify th�t I have read and examined lhis application and know the same to be true and correct. AII provisions of laws and <br />ordinaces governing lhis type of wor!c will be complied with whether specified herein or not. The granling of a permit does not presume <br />to give authority to violate or cancel lhe provision of any other slate or local law regulating construction or lhe performance of <br />conslruction. That I am authorized by lhe owner of this propeAy to perfortn lhe work for which application is made and I comply with the <br />State Co actors Law 18.27 RCW and 296.200 WAC. <br />�,� G���S�o � <br />� Wre of OwnedConlreclodAuthorized Agent � D t� ��L <br />