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�'cRMIT APPLICATI�JN <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 />58�8 Ft��,�✓�, si <br />LEGAL LOT N0. BLOCK <br />DESC. <br />/��h�,� y t� <br />TENANTNAME <br />1°o t�j✓ D <br />6nIrtY (=• luLl7�v�J <br />PARCEL TAX I.D. M <br />TRACT OR SUBDIVISION M <br />5`8�S l=1�iy�.i�l ST, e <br />CONTACT FOR PERMIT <br />ll��v�y �?, �v � �.v�� <br />L1tiRvi p�a" pzs�(<�J r�uKr <br />CONTR. UCENSE N ti �_ y�G 1 G�3 <br />USE OF BUILDING <br />R �� <br />dt <br />�,�� 13 S�E �-3�rN <br />r«� w,� �1$G3I <br />HE.AT SOURCE <br />_ Eleclric _ Gas _ Other <br />WORK DESCRIPTION �j �, QL� i L 17 /�, i</Jr�✓ <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavalory (wash basin) <br />Shawer <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/bar/mop/elc.) <br />Backilow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />' �y�'i <br />t : <br />� <br />`__ -, <br />_ <br />�� - � <br />[tMITJ�V "'_' <br />�E Crcc�lf� <br />yR5 2.38-�960 <br />PHONE y�,S�,39-a7G< <br />9803! Z oG RG/-�y/8 <br />CONTRACT PRICE OF WORK <br />� 3 3� c��$"3 8B <br />hFi ¢R-. r�t� Q,V,vtd/i� <br />NO. <br />TYPE OF FU(TURE OR ITEM <br />A/C — 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 />Heat pump <br />Unit heater <br />Boller <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this applicalion and know the same to be We and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or rwt. The granting of a permit does not presume <br />to give authority to violate or cancel the prcvision of any other slate or local law regulatlng wnstruction or the peAortnance of <br />construction. That I am authorized by the owner of this property to peAorm the work for which application is made and I comply with the <br />State Conlractprs :aw 18.27 RCW and 296200 WAC. <br />—�iti_'j<<G� G,.-z <br />