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SITE ADDRESS <br />13�5 �[ �ve <br />LEGA!{ LOT N0. <br />DESC.r <br />TENANTNAME <br />PERMIi APPLICATION <br />CITY OF EVER�TT PEFiMIT �ERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-BS10 - FAX h?.5-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />FARCEL TAl( I.�. # <br />BLOCK � I TRACTORSUBDIVISIONN <br />`j"'��.,,��s YV�ecllwhicc�L PLks <br />CONTR. LICENSE p <br />USE OF BUILDING <br />q-�l-oS� <br />PERMfT q <br />_ov� <br />CONTACT FOH PEFMIT PHONE 3(�, .�g/o- �,Z2 � <br />1 l�"'� LtX�� � EaJIAIL � n,ca( <br />No r�c tin�c � Lc��-e V�r.� j a(�,,���, ,,��+ 9$S$Fl <br />HEATSOURCE <br />� Eleclric _ Gas _ Other <br />3r.n-ag6 -/z� <br />CONTRACT PRICE OF WORK <br />�,5 ��o, oG <br />WORK DESCRIPTION � � � <br />Zns�l� Qr�--�e�i o4ti-�cr.,r' w«lk-��. -Frecze� 6 x g <br />ryp, � �NPE OF FlXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heator <br />Sink (service/bar/mop/etc.) <br />8ackfiow preventer <br />Urina� <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other ___ <br />:[•71 <br />TYPE OF FIX7URE OR ITEM <br />A/C •• air handling unrts <br />Fora3d air systems <br />Gas piping <br />wate�r heater <br />Gas lireplace <br />Gasrango <br />Clotl�es dryer <br />Ran��o hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boil[u <br />Refr geration <br />Wocdslove <br />OlhErr <br />CITY OF EVERETT LOCAL SAi.ES TAX COUE IS 3105 <br />I hereby cori:ity that I have read and ezamined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces goveming this type of vrork will be complied with whether specified herein or not. The granting ol a permil does not presume <br />to give authonty to violate or cancel the provision of any olher state or local law regulafing construction or the performance of <br />construclion. Thal I am authonzed by the owner ot this property to pedortn the work for which applicahon is made and I comply with ihe <br />Stat �/lr�— La�-18 27, CW and 296.200 WAC. <br />/ �-- �-K-UrI <br />