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�,�_v, �c �(�iib—i2:19P�V—Dou.�. �v�,nwo���! �r��azd <br />91TE AD�RE99 <br />LEG � LOT N0. <br />�ESC, � <br />TENANTNAME <br />CONTRACTOR <br />AkRO� :� <br />usr: or- sui�oiNc <br />� �RMIT APPLICATIUN <br />CITY OF EVEREiT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www,everettwa.org <br />APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />�� <br />CONTACT FOR PERMIT <br />Dvv� c.�s �k <br />ADDRE6S <br />HEATSOURCE <br />� Eloctric _ Gas _ Other <br />CITY2IP <br />��0.19�6--F'• 2 <br />pERMIT 1f <br />7 <br />���7 <br />CONTRACT PRICE OF WORK <br />���Q� � <br />WORK DE9CRIPTION �iFM�jL(77�J,�f S�/�.�}i J�G •,�OD SQFl. ��Ulc.ditil4 b+� .Gf��'A' <br />�vo aF ��aTy. f/� sr�� �v,�rra�.► �% 3rxvc�vRacc,y , <br />�47�r,�� 7� d <br />NO. I TYpE OF FIXTURE OR ITEM <br />Tollel <br />Bathtub <br />Luveiory (wash basin) <br />Shower <br />Kilchen slnk 8 dleposal <br />Dlahwnaher <br />Clolhes washer <br />Water heater <br />Sink (servlco/barlmop/etc.) <br />Bockflow preventer <br />Urinel <br />Drinkinp Founteln <br />Floor droln <br />Groeso trap <br />roof dralns <br />Other <br />N0. � TVPE OF FIXTURE OR ITEM <br />AIC — elr handllnQ Units <br />" Forced elr systems <br />_ Gas plping <br />Waler hester <br />_ Ges flreplace <br />_ Gas range <br />Clathes dryer <br />Renpe hoad <br />_ Exhaustfan <br />_ Hea! pump <br />Unit healer <br />_ Bolipr <br />_ Ref�lperalion <br />Woodetovp <br />Other _ <br />CITY OF EVERETT LOCAL 9ALE9 TAX CODE IS J10E <br />I horeby corlU(y that I hove read and examined thls application and know thp g�me to ba irue and corfect. NI provlslon9 ot laws'and <br />ordlna�:es governing thls type of work wlll 6e compiled wilh whethor epeclfled herein or not. The pranting of a pormlt does nol preeuma <br />to plwe aulharlry to vlolate or cancel tho provlslon of any other etate or local law regulatinp conswcUon or the p�:dortnence of <br />cons:ruction. Thal I am a orized by the ownor of thls propeRy to parform the work forwhlch appllcatlon is meda end I comply wilh the <br />Stet�3 Conlraclors Leyv�7 RCW and 298.200 WAC. <br />