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SITE ADDRESS <br />LOT <br />P�RMIT APPLICATI(:,dV <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 />BLOCK � TRACT <br />PARCEL TAX I.D. # <br />2�10S1—i002131U <br />� l..- �. I-�ob,5 <br />'�� �;9 -Z7' <br />vrrn�n "__"___ \.'" J <br />t��►+-' `s`rr���:� P�aN�.s �Lc. iaiq� �i�u�c�� t-�vk��_�o �• �w�•�l <br />� �-�.,� P� �t ���. �i�2,� <br />TENANT NAME CONTACT FOR f: R�11T PfiONE <br />. I CJ1��� �.4(�-al-'_�. �'CZJJ7�Gi�_LJ•_.1�.;� ., <br />CONTRACTOR ADDRESS CITY2IP PHONE — <br />CONTR. LICENSE # . �, <br />USE OF BUILDING <br />2�s� c�� �� A..�. <br />. . � , <br />HEAT SOURCE <br />�� � �. _ [Ieclric _ Gas _ Olher <br />WORK DESCRIPTION <br />�_��_�r� I c�� � l�. <br />�: c <br />_ _. �� cz� � �: �... _�. <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposai <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greaso trap <br />Roof drains <br />Other <br />CONTRACT PRICE OF WORK <br />� C7 E�CX..� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas rango <br />Clothes dryar <br />Ranc�e hood <br />Exhausl (an <br />Heat pump <br />Unil heater <br />Boiler <br />Retrigeralion <br />W�odstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify Uial I have read acd examined lhis application and know lhe sama lo be true and correcL All provisions of laws and <br />ordinaces goveminc� this type of work will be complied with whether specified herein or noL The granting of a permit does not presume <br />lo glve aWlLo,rity to``((iolale or cancel the provision of any other slale or local Iaw regulating construclion or the pedormance of <br />construclion:iriaT[pr�aulhorized by tho owner ot this properly lo pedorm the work for which application is made and I comply wilh the <br />State Cop�actors L�b\8.27 R�W and 296200 WAC. <br />�IL <br />