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oa;osi•�oia �rur. ia:as rns azs a�s �oas H'A Nnturnl cus <br />� <br />SITE ADDRESS <br />y9/B • <br />LEGAI. LO NO. <br />D[SC. o � <br />OWNER <br />TEN TNAM� <br />coN Rn o ,/� <br />CONTR. LICENSE # <br />/�� <br />USE OF BUILDING <br />SrQ t..�'� <br />l <br />I�ooliooz <br />y�s-3�7-1 y 1 � <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES 4�-I �--.'3 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wvuw.evereltwa.org <br />APPLICATIONS ARE ACCEPTEU FROM 8 AM TO 4 PM <br />BLOCK <br />3. <br />PARC'eL TAX 1.�. # <br />'!H 9.S'� -a -/o / - d� ' <br />TRACT OR SUBDIVISIQN # <br />CONTACTFOR <br />��Ir w C2�� <br />�on�d #'ZC� <br />—75c�-7 <br />PERMIT # <br />m�>���-���>;_ <br />iONEy Z 5, <br />/76o���s_ <br />y 25-�`+ ( - 14t4 <br />�cvc_cc�' Gv/1 <br />98'zoy <br />�25 •3�� <br />HEA7SOURCE CONTRACTPRICEOFWORK <br />[lectnc ,� Gas _ Other ��d <br />WORK DESCRIPTION ��Q�� ��x� ��F <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />J Bathtub <br />Lavatory (wash basin) <br />Shower <br />ICitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Wa;er heater <br />Sink (servic�:lbar/mopletc.) <br />Backllow preventer <br />Urinal <br />Drinking Fountain <br />floor drain <br />Gresse trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas freplace <br />Gas range <br />Clothzs dryer <br />Rangehood <br />Exhaustfan <br />Hcatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woalsrove <br />CITY OF EVERE7T LOCAL SALES SAX CODE IS J105 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />erdinances goveming this rype of work will be complied with whelher specified herein or no.. The granting of a permit does not presume <br />to give authonry to violate or cancel the provision of any other state or local 12w regulating construction or the performance of <br />construction. Thal 1 am aulhorized by lhe owner of this property to peAorm the work for which application is made and I comply with lhe <br />��ate Contractors Law 1827 RCW and 296200 WAC. <br />. /'.,_._' y-9-- 1 3-- <br />co eh <br />