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SITE ADDRESS <br />LOT N0. <br />P..RMIT APPLICATIt,N <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 />v Gi9AiE <br />BLOCK <br />TRACT <br />PARCEL TAX I.D. # <br />S -J 6 - 0,6 <br />yP�^ERMIT q <br />'V`C�CJ - �>�` <br />DESC.r I I <br />OWNER ADDRESS CITYlZIP�u�J��HONE <br />� ��v <br />�02 � S-t. /��9�i1/C�2 S LL C/,2I �' �/«AG�6�. �.�'o.Zo 3 Y2s�- 3 Y� D`�e � <br />TENANTNAME I CONTACTFORPERMIT PHONF <br />CONTRACTOR <br />Ei�/1�t� S � • f/�T ' f1 �c <br />CONTR. LICENSE !! <br />�-vFnl fs � za-oT <br />USE OF BUILDING <br />ADDRESS CITY/ZIP PNONE <br />�/,�o PAt�.�ic �9r,�- Gv �5�� ,2�� - 3/i l <br />G�S//,/E�v�siZ I <br />WORK DESCRIPTION <br />G4S �l�P,�t/i9CE '� QGc � <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servico/bar/mop/etc.) <br />Backflow provenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Greasa trap <br />Roof drains <br />Other <br />HEATSOURCE <br />_ Electric �Gas _ Othor <br />CONTRACT PRICE OF WORK <br />�y,s�a <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Forced air syslems <br />Gas piping <br />Water healor <br />Gas fireplacs <br />Gas range <br />Clolhes dryer <br />Rango hood <br />Exhausl (an <br />Heat pump <br />Unil healer <br />E3oiler <br />Rofric�eralion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I heroby coritity lhat I have read and examined this application and know the same to be lrue and correct. AII provislons oF laws and <br />ordinaces governing this typo of work will be complied with whether specifiod herein or not. The granting o( a permit does not presume <br />to give authonry to violate or cancel the provision of any other slale or local law regulating construclion or the pertormance of <br />consWctio� That I am authorized by lhe owner of Ihis proporty to per(orm the work for which app�ication is made and I romply �vith the <br />Slate�ontra�tors Lav,�18.27 RCW and 296.200 WAC. <br />��1 <br />