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SITE ADDRESS <br />�}-02 �1��rr' <br />LEGAI LOT NO. <br />DESC. <br />F'�RMIT APPLICATIvN <br />CIl"Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, W.A 98201 <br />425-2=7-8810 - FAX 425-'257-8857 - www.everettwa.urg <br />APPLICATIONS ARE ACCEPTED FROM 8 F.A4 TO 4 PM <br />PARCEL TAX I.D. # <br />�� Wa� :-�OUSl�oU40/ <br />BLOCN TRACT OR SI:BDIVISION # <br />S��Asr� �v���rr nnau. L1-c- 43G3 UC��I {��"�aaJ A� � 300 �r� zx��f �.aC/�• <br />TENANT NAME CONTACT FOR PERMIT PHONE �2lp(p0 <br />I �2� 2Sy-o064� <br />� <br />� <br />CON'fRACTOR ^"",•""' --- - <br />r"l- eQou�N c.cnf�cno�J �253 fZUsK-+�1 D�. M�cFoKo, o� ��!� `i4'� -1�22 <br />CONTR. UCHNSI= R G1�-C.�C�(- <br />USE O� BUILDING <br />�.E 1 Lk t L� <br />4VORK DESCRIPTION <br />i�:nU-ARCv� <br />�ND �O�pi <br />��5in1 Cr <br />HEATSOURCE <br />_ Eleclric 1/Gas _ <br />Olher <br />CONTRACT PRIGE OF Wuhcrc <br />��{'� 35�'� <br />ekrt�i�, A�P CE�NSnn,b) I3N 4�c.ro�inJ6 �.�15,1n�(� •�teRPCo� 2nonn <br />�.�.cy��nJ� 13AC,I� ��mR� 1-o Tf� �JEc.� n1�'c0; 13� t'RoU�i�W C- �U�tJ <br />S. <br />NO. I NPE OF FIXTURE OR ITEM <br />�t <br />Balhlub <br />Lavalory (�:�sh basin) <br />Shawer <br />Kilchen sinl; & disposal <br />Dishwasher <br />Cbthes washer <br />Water �iealer <br />Sink (service/badmop/etc.) <br />8ackflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I T: PE OF FIXTURE OR ITEI�1 <br />AlC — a�r handling unils <br />Forced air syslems <br />Gas pipiny <br />W aler heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust (an <br />Heal pump <br />Unit healer <br />6oiler <br />Re(rigeration <br />Woodstove <br />Other _ <br />CITY OF EVERETT LO(.AL SALES TAX CODE IS 3105 <br />I hereby cerilify Ihal I have read and examined this aoplicalion and know lhe same fo be lrue and correcL All provisions �f laws and <br />ordinaces yoveming this rype of work will be complied �vilh whether speci(i�d herein or noL The granting oi 2 permit does nol presume <br />to give authority to aiolale or cancel the provision of any other state or local law rec�ulating construction or the ped�rmance of <br />construction. That I am a}+ lhorized by the owner of this property to perform lhe work for which applicalion is made and I comply with lhe <br />Stale Contraclors La�v y8.27 RCW and 296200 WAC. <br />ent <br />