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� - <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.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� _/'} �-((� <br />SITE ADDRESS PARCEL TAX I.D. *(pDC� P�j%� �_� <br />151v 5� EV�K�T MA6l. i�-vb 5u�trc P> 2�5 I� 4o I tC� �D <br />LEGA LOT NO. BLOCK TRACT OR SUBDIVISION E <br />DESC. <br />ApDqEgg CITV2IP PHONE <br />�GD �YI7H'SCN �/ /- _ <br />"r1C�3jI7P�� '�1�/ % �� "' ' � ACT' FOR ERNIIT�%� �� P►y+�N��i£34o5 oc� <br />7ENANTNAME p �L <br />�j,L� 1'��.�J '� N�i`: ��tVIiCF: I���\'���G� E�AAIL JfWlrn�t�tYt�1G���11 <br />�vCk �`��i,irfiA!% �O • 23��3 I' <br />CONTR.UCENSE �D�� ��3,KJ � <br />i'� / <br />USE OF BUILDING <br />r��-,�+u, �cad <br />WORK DESCRIPTION <br />�NAur 1M�GauF<cL'� <br />lN1�P-ee. �tNl�x�f�S• <br />�-�"i 5 7�5 Mo�N�S <br />L 7/J2 <br />HEAT$OURCE <br />ElecVic �Gas_Olher <br />2oro 7�i5 -4Z7 � <br />� �� <br />CONTRACT PRICE OF WORK <br />94�D - <br />�Q„ �uc., �cpc1. P�'ivtr�L C'W�^Pxf� � t��w ��a�''MQc{t'� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 dispos� <br />Dishwasher <br />Clothes washer <br />Fountain <br />Other <br />NO. <br />TYPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas firepl <br />Gas ra e <br />Clot s dryer <br />R ge hood <br />xhauslfan. <br />CIT' OF EVERETT LOCAL SALES 7AX CODE IS �706 <br />I hereby ceAify that I have read and examined lhis applica6on and know the same to be true and corted. PJI provisions of laws end <br />ardinances goveming this type of work will be compiied with whelher specified herein or not. The granting of a pertnit dces not presume <br />to give authority to vlolate or ancel lhe provisian of any other state or local law regulating consWction or the perfortnanca of <br />construdion. That I am authorized by the owner of this property to perfortn the work for which application is made and I coinply with the <br />Stete ContractorpLaw 18.27 RCW and 296.200 WAC. <br />ll•2�t0 <br />oe,e 1T2 <br />