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P��RMIT APPLICATIC,N <br />CITY OF EVERE7T PERMIT SERVICES <br />3200 CEDAR STREE7, EVERETT, WA 98201 G-/o • 05 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �,,,�,,1 � // ` � � S <br />�- y, S (r r�rt •r <br />APPLICATIONS ARE'ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />1�3 - l�orn <br />LEGAL LOT N0. <br />GcSC. I I <br />� <br />BLOCK <br />15 <br />PARCEL TAX i.D. # <br />TRACT w. <br />CrIB.oS <br />MIT # <br />� (n � <br />�� � <br />.iaw►a� mal�w,oud 13330 6�Nd mr S� Ever+e�i` 4��og 3�8-90�0 <br />TENANT NAME CO4TACT FOR PERMIT PHONE �� �I <br />.low�n,! Mal�wtal,�� I�aw,aL Mah�oud �4Yi 3�g- �.C� <br />CONTRACTOR MQ��er If� u(Laer <br />v� <br />CONTR. LICENSE # A. }1 <br />,.i i <br />USE OF BUILDING <br />E6 <br />AOORE55 'l^� � � ,., CITY2IP <br />3-��-� weSterLy �Lh <br />012�N <br />RiMbr� $ <br />HEATSOURCE <br />y� Electric _ Gas _ Other <br />WORKDESCRIPTION A f+acH 3�v�✓� l�ouse L� l.'XIS'f�Ng <br />Te he� �o�..�hGou� i S �tiree SfivrieS. 2-f3ed►aon1, <br />i5 N. 54�1 SF• Iwtpwue �► e Si4e a� • tri �+ <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEI.1 NO. I <br />Toilet <br />Balhlub <br />Lavatory (wash basin) <br />& disposal <br />Clothes washer � <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urnal <br />Drinking Fountain <br />Floor drain <br />Grease irap <br />Roof drains <br />Other <br />� <br />PHONE '�p 6 <br />C�2-�3i� <br />CONTRACT PRICE OF WORK <br />�3o565a <br />tvwr owSe burtd.�►�. <br />I•5 ba.�ti, eac.l� �r <br />U2rkitl�l ln� � 25�. <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clo hes dryer <br />E>;haust fali. <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY Of EVERETT LOCAL SALES SAX COOE IS 3105 <br />I hereby ceritify that I have read and examined this application and kno�v the same to be true and correct. All provisions of laws and <br />ordinaces goveming this type of �vork will be complied �^ith whether specified herein or not. The granting of a permit does not presume <br />to gi�•e authonty to violate or cancel lhe provision of any other state or local law regulating construction or the performance of <br />construction. That I am au.horized by the owner of this property to periorm the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />`.�)�C !<,��� <br />1I� <br />