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.� <br />SITE ADDRESS <br />I �z— S� � <br />LEGA LOT NO. <br />DESC. <br />, <br />PERMIT APPLICp►TION <br />CITY OF EVE;RETT PERhAIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-9810 — F/�X 425-257-8857 — wYv�r.everettwa.org <br />APPIJCATIONS J4RE ACCEPTEU FROM 8 AM TO 4 PM <br />trGf� M�1GG t�17S I <br />� BLOCK TRACT <br />PARCEL TAX I.D. M <br /># <br />5�r�.+•�&Asr �N."�t�C�'(r �r��,;-�;e5 �yo2 SLtuc%L��MAG�uJ9Y u�A yzr3zZ��r�y— <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />Z�.r4iz- I��/irj �'1(��vrJl�S 316-32�-63dd x lo <br />CONTRACTOR <br />CONTR. LICENSE p <br />USE OF BUILDING <br />/✓j <br />�/ c <br />�Jv ��CJ �� <br />WORK DESCRIPTION <br />� Lc,,�Rr� r F. (' ov� <br />NO. � TYPE OF FI%NRE OR ITEM <br />Toilet <br />Bathtub <br />Lavarory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbar/mopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease hap <br />Rooi drains <br />Other <br />ADDRESS CITYZP <br />� /�TJ � �/,�O �lJ 7 <br />lY <br />— HEATSOURCE I <br />Electric Gas OU�er <br />PMONE <br />CONTRACTPRICE OF WORK <br />S S, �S'Dd <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC - air handing units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustian <br />Heat pump <br />Unk heater <br />Boiler <br />Refrigeration <br />Woodstove <br />GTY OF EVERETT LOCAL SALES TA7( CODE IS 3705 <br />I hereby ceri0ry that I have read and ezamined this application and know the same to be true and corted. All provisions of laws and <br />ordinaces governing tliis type of wak will be complied with whefher specified herein or not. The grentlng of a permit does not presume <br />to give authorily to violate or ca�cel the provision of any other state or local law regulabng construc6o� or the pertormance of <br />conshuctlon. That t am auMorized by the owner of tlds properly to perfwm the wak lor which application is made and I comply with the <br />Stale ConAactors Lay✓-1821' RCW and 296.200 WAC. . <br />y H o� <br />Da!e �/i� <br />