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��I 5��� <br />SITE ADORESS <br />-ot-a-� � <br />LEGAL LOT NO. <br />DESC. <br />�ERQVIlT APPLICATIOf� _ <br />CITY OF EVGRETT PERMII' SERVICES `i��C�-C�a,?�I <br />3200 CE�AR STREET, EVERET'� , WA 98201 � <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.ory ( � �� /� <br />� `� <br />�)APPLICATIONS ARE ACC�PTED FROM e AA1 TO 4 PM� �D��,� ����-��';'i-'�/ <br />BLOCK <br />��i t��-'ai`-`1— {-Z'-�4'�c Lti <br />TENANTNAME <br />�- Pa o r �A-�t <br />CONTR. LICENSE p <br />PARCEL TAX I.O. # <br />I IS��� —6` <br />TRACT OR SU801VISION # <br />RMiT a — -- <br />�11.� - �73 <br />FWHk�S t�I1PQY rnvno Zsj <br />�� �-�-�-f Ll(.,Sa+�.l C21� l��k�Fu- re <br />�t ��:.-�!� �� —�.�:3 <br />CONTACT FOR PERMIT PHONE Z�o 2�3 �}"� C <br />MI�F= ��r�-. E-MAIL�,�~ � L�� <br />y —�c�N�� r—,���..� <br />T� t� "" <br />i -�- . <br />!v�L�h ��'�_'tCcc; � <br />USE OF 6UILOING — — HEAT SOURCE <br />%��y-�'� � � Elec4 ic __e Gas _ Other <br />WaRK DESCRIPTION <br />��-.�.� -� �-�-�F i��Z�vr �-i,� ��s�iz�ss� <br />yaF^rf'-f,("y sj"���-a�'iVIZ�- �/� )�, <br />NU. � TYPE Of FIXTURE Oq ITEM <br />Toilet <br />BatMu6 <br />Lavatory (wash basin) <br />Showar <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher �Lc�- ��,i� _ <br />��;��i��ll?)LJ <br />� �� , <br />CONTRACT PRICE OF WORK <br />a"t �j.r�� lj o 0 <br />����.��.lP"c FL�(t�cr <br />NO. � TYPE OF FIXTl1pE OR ITEM <br />!v'C - air handling units <br />Fnrced air systems <br />Gas piping <br />Water heator <br />Gas (ireplace <br />Gas range <br />Cloihes dryer <br />Range hood <br />Exhaustfan <br />Heatpump <br />Unit heaier <br />Boiler <br />Relrigeration <br />Woodstove <br />GTY OF EVERETT LOCAL SALES TAX COpE IS 3105 <br />I hereby c r' ity that I have read and ezamined this application and know the same to bo true and conect All provisions of laws and <br />ordinac overnin� this rype ol work will be complied with whother specitied hurein or not. The granting of a permit does not presume <br />to pive thoiiry to violata or cancel the provision of any mher state or local law regulatinc� wnstruction or the portormanca of <br />cons f' �ion. That I am au orized by Uie owner of tl�is property to peiform tlie work lor which apptication is made and I comply with the <br />Stata acto� 27 RCW and 296.200 WAC. <br />