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PE,ZMIT APPLICA`�10�� <br />CITY OF EVERETT PERMIT SERVl�ES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />42.5-257-8810 — FAX 425-257-8857 — ww�v.everettwa.org <br />APPLICATIONS AkE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS AR'e NOT ACCEPTEG <br />SITE ADDRESS <br />i�-U2 �.� <br />LEGAI LOT NO. <br />DESC. <br />s ��,� p �� � T <br />��.�%�:� j� tV��1��. <br />BLOCK <br />�n�'✓I ('�N <br />PARCEL TAX I.D. # <br />TRACT <br />PERMIT # <br />z�R��i ►�� w��� �; c�l s j�,������,rtE w���r�T ����crl �, <br />TENANT NAME CONTA T FOR PERMIT PHONE C�f} �'� Q/� (� G <br />— J���C� I:�li�=� ��� 42�.4�3 I� ° <br />CONTRACTOR >�����.�/` C(,1 (� ADDRESS 2 �J �� 5 I 3 U L. �� IT`/ZN � PHONE a 2 5 2 ��- <br />Jy 7 q- <br />CONTR.LICENSE# (7�C ?�O/ �Z��LUV�C �fI -/�'�GG� <br />USE OF BUII_DING � HEAT SOURCE � CONTRACT PRlCE OF WORK <br />_ Electric _ Gas _ Olher � � � , � � J <br />WORK DESCRIPTION <br />�t�o�bSrr� 61,4h h►��I,T�"{�. <br />NO. , TYPE Of FIXTURE OR ITEM <br />� Toilet <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />i Grease trap <br />Roo( drains <br />Olher _ <br />N0. I 7YPE OF FIL'IURE OR IT[h7 <br />A/� — air handling wiils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas f replace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />U�it heater <br />Bailer <br />Refriyeretion <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby ceriti(y that I have read and examined this applicalion and know fhe same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein o� noL The aranting of a permit does not presume <br />to give authoriry to violate or cancnl the provision of any other state or iocal law regulating construction or the performance of <br />construction. That I am authorized by lhe owner of this property lo perform the work for v�hich application is made and I comply with the <br />Stale Conl�r rs Law 1027 RCW and 296.200 WAC. � I 5' <br />( il �'v� I�� i�rJC�,I GI "�"� 5 2 U� <br />�9� <br />�� <br />