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SRE ADORF.SS <br />PERMIT APPLICATION <br />CiTY OF EVERETT PERMIT SERVICES <br />�200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -wv�w.everettwa.org <br />APPLICATIONS ARE ACCEPTEB �ROM 8 AM TO 4 PM <br />��1� -' ��� I PARCEL TAX I.D. if <br />; L 1 SG CvC-2C- +�- M�}f.l., l�fY! I <br />LEGA LOTNO. I BLOCK TRACTORSUBOMSIONf <br />7�.i � V` �. C' l <br />N���Sc�� C...�r.-c•—G--� <br />TENANT NAME CONTACT FOR PERMR � PMONE Z�(o "� (,1 2 31 y <br />vL�f Mf�IC... �i'D7�' ' I U� I�A� ��Cli-LC,� J�C`� �-MAyL� r1Cc�� s�Jn�t.�1 ciw.�i <br />tv Cc�, S� Cru 't! P 1.�.,t� t �.�i <br />COHTR. LICENSE R <br />1�I Gor� r 55 A -� <br />USE OF BUILCING <br />f�CrUL vX SUL.9 P� S 5C—�'+TL£ L,•�V <br />3 (, Lj— <br />HEAT SOURCE <br />_ Electric _ Gas _ Olher <br />WORK DESCRIPf10N <br />I rv ;� .Va iL LZ � � C W \tii n �L 5 l l,-n.t S <br />NO. I TYPE OF FlXiURE OH fTEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shovver <br />Kitchen sink & disposal <br />Dishwasher •_ <br />Clathes washer <br />Water heater <br />Sink (sorviceibar/mop/etc.) <br />Bachllow preventer <br />Urinal <br />Dnnking Fountain <br />Floor drai n <br />Greaselra� <br />Rool drains <br />Olher <br />GL <br />CAHTRACT PRICE OF WORK <br />�� <br />�#'-75'00 <br />NO. � TYPEOFFlXTUREOflITE61 <br />NC — air handling units <br />fbrced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />RelriguaGon <br />Woodstove <br />CfTY OF EVEREiT LOCAL 9ALES TA% CODE �S 3105 <br />I hereDy centily that I ha�e read and examined this appiication and know lhe same to be true and correcL All provisions ol laws and <br />ordinaces governing ihis type ol work will ba complied wilh whelher specified herein or nol. The granting of � permit does not p2sume <br />to give authority to violate or cancel the provicion af any other state or local law reguialing construction or the perlormance ol <br />consiruction. That I am authorized by the owner of this property to peAorm �he work lor which application is made and I comply with the <br />State Convactors Law 18.27 RCW and 296.200 WAC. <br />1 <br />ti%z /U'7 <br />�Z <br />iF� <br />