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SITE ADDRESS <br />LOT N0. <br />F'�_RMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />32U0 CEDAR STREET, EVERETT, V�iA 98201 <br />425-257-8810 — FAX 425-257-8857 — , rvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK I TRACT <br />PARCEL TAX I.D. tt <br />s-�6-06 <br />PERMIT # <br />DESC.r I I <br />OWNER AODRESS CITY21PMu���HONE <br />�'D <br />ia � s-t, .�rrticn. s�c c/�� �i yicc�G�G�. �,�'�20 3 yzs- 3 Ys o2r � <br />TENANT NAME � CONTACT FOR PERMI7 PHONE <br />CONTRACTOR AD�RE55 <br />E1.�!',Gll.et�w s %� L/F�7-T •.9/c ��,zo PAC�•r� .9r� <br />CONTR. LICENSE # <br />�vEnGSs � z�-o i <br />USE OF BUILDING I HEAT SOURCE <br />QJf-5�����Z _ Electric �Gas _ <br />/i� <br />WORK DESCRIPTION <br />G9s �r�Nr9� K ,/�u � <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BalhWb <br />Lavalory (wash basin) <br />Showor <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (sorvice/bar/moplelc.) <br />Backflow prevonter <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Greasetrap <br />Roof drains <br />Other <br />CITYIZIP PHONE <br />Cv �i'8�oi ,2�� - 3/r % <br />Other <br />CONTRACT PRICE OF WORK <br />'`�'�/, SY v <br />NO. I 7YPE OF FIXTURE OR ITEM <br />FVC — air handlinc� unils <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas firoplace <br />Gas range <br />Clolhes dryer <br />Rango hood <br />Exhauslfan <br />Final pamp <br />U;iit hoater <br />Boiler <br />Refrigeration <br />Woodslove <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 5105 <br />I heroby ceritify that I have read and examined lhis application and know tho same to be true and correcL All provisions of laws and <br />ordinaces goveminn this type of work will be complied with whother spoci(iad herein or noL The granting oF a permit does not presume <br />lo give aulhority to v�olate or cancel tho provision of any other stato or local law regulating construction or the pedormanco of <br />conslruc)icx� That I am aulhorized by lhe owner o( this property lo perform the work for which applicalion is mado and I comply wilh lhe <br />�Stat �ontr tors La 1827 RCW and 296.200 WAC. <br /><"� i�� �S ��— �� <br />