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l �. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <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 />l O5 �t,�rtli- m0.11 <br />LEGAI LOTNO. BLOCK <br />DESC. <br />OWNER <br />E�e�e� w,al� L.L.L <br />TENANTNAME <br />S ��. <br />r IYl C <br />CONTR. LICENSE # <br />USE OF BUILDING <br />�e�ra:�� <br />��. .� � <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION # <br />CONTACT FOR PERMI7 <br />F� o d &�s�Q� <br />A—oo�o 8 �4�.b�,r�� la <br />vo fi'��R <br />HEAT SOURCE <br />_ Eleclric iC Gas _ Other <br />1-1�-0� <br />PERMIT # <br />M o�sv� - c�3r <br />PHONE `/ � <br />bA�r. <br />_9�266 <br />CONTRACT PRICE OF WORK <br />� �, DOo� <br />WORK DESCRIPTION �u�C �� i� w� <br />�e,�\ac.e ex�s��� S-I�o� '�o� � <br />hew .S-�-a� r6��P uv���-�I�nod;�y �c�s-F�n' 9us ,�tPe. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />AIC — 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 />He2t pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify �hal I have read and examined lhis applicalion and know the same to be true and correct. All provisions of laws and <br />ordinaces governing lhis type of work will be compliod with whether specified herein or not. The granting of a permil does not presume <br />4� give authorily lo violate or cancel the provision of any other slate or local law regulating consWction or the perfortnance of <br />conslruction. That I am authorized by the owner of this property to perform the work for which applicalion is made and I comply with the <br />State CoNr lors yaw 18.27 R W and 296.200 WAC. <br />� . I � �,.� �-�X-zOUg <br />