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SITE ADDRESS <br />LOT IJO. <br />F �RMIT APPLICATI�.N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA £8201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIOKS Al2E ACCEPTED FROM 8 AM TO 4 PM <br />/ �/9/7/F <br />BLOCK TRACT <br />PARCEL TAX I.D. ri <br />� s _Ib-o!o <br />PERMIT# <br />� � <br />V��I�CR nvvncaa v�� ��c <br />Mu C / <br />�02 � S�`, /�fl�il/L71.S LLC /�l�/v/CcqG�62. J�i,�'�203 �1,�-3YS D`�v) <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />�/1��. s �.,�-T • �9�c a�,�o PAt��c Ac�- cu fd �� 2�� - 3�� % <br />CONTR. LICENSE # <br />����s � Z�� � <br />USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br />�//%E��i� <br />WORK �ESCRIPTION <br />G9s �r,o�u.9cE � pu � <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Showor <br />Kitchan sink & disposal <br />Dishwasher <br />Clothos washer <br />Laundry tray <br />Sink (service/barfmop/elc.) <br />BackOow preventer <br />Urinal <br />Orinking Fountain <br />Floor drain <br />Grcase trap <br />Roof drains <br />Other <br />_ Electric �Gas _ Other <br />'`y��/, SP D <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air system� <br />Gas piping <br />W ater heater <br />Gas firopl�cs <br />Gas renge <br />Cbthes dryer <br />Range hood <br />Exhauslfan <br />Heat pump <br />Unit hoaler <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />I hereby corilify that 1 have read and examincd this application and know the same to bo lrue and corrocl. AII provisions o( laws and <br />ordinaces goveming this type of work will bo complied wilh whether specified heroin or not. The granting oF a permil does nol presumo <br />to give authority to violate or cancel the provision of any other stato or Iocal law regutating construction or tho performance of <br />conslruclio�l That I am aulhorized by lho owner of this pmperty to periorm lhe work (or which applicalion is mado and I comply �vilh Iho <br />SlatH2�onlr�ctors Lav,`18.27 RCW and 296.200 WAC. <br />