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� <br />PERMIT AFPLICATIOM <br />CITY Or� EV�i2ETT PERMI7 SERVICES <br />3200 CEDAR :.TREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.sverettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />l�l-G�- ,%r EVCs�I-�F-�IY1�tt-1, <br />LOT NO. I E3LOCK I TRACT <br />DESC. <br />TENANTNAME <br />�v��'.k=� i ,�1 r1 t�-- <br />CONTRACTOR <br />CONTR.LICENSE# Tg,1/ <br />USE OF BUILDING <br />Ev�Y�e-�li �(hLL <br />PARCEL TAX I.D. # <br />CONTACTFORPERMIT <br />��.��iEu�yN -R;r�.��c_�- <br />ADURESu <br />RMIT # <br />L I /1 _ <br />PHONE <br />C(�c�.)�fCl� �C�I jc 'rJ <br />PHONE <br />HEAT SOURCE CONTRACT PRICE OF WORe: <br />Electric Gas Other �`-P 5���� <br />WORK DESCRIPTION ��S � A_L� "j'W�1 N��tJ- 11,Li.�Jrj�iJ/}�j"t'� <br />W�L�. �iGtJ� u.s ��•�i�c�-I�.oi <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toiiet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposa� <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 />Grease trap <br />Roof drains <br />Olher <br />7 - ���x `q�_ 6�� <br />�1 �-; {-e_ �1.a-11 <br />NO. I TYPE OF FIXTURE OR ITEM17 <br />NC — air handlin9 units <br />Forced air systems <br />Gas piping <br />water heater <br />Gas fireplace <br />_ Gas range <br />Ra�nge hood r �L ' � � <br />_ Exhaust fan �/ � i 2 S <br />_ Heat pump . � �I <br />Unit heater � �/ _ <br />_ Boiler /�n�/ �� � <br />_ Refrigeration <br />Woodstove <br />= Other V <br />�� <br />� <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisians of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The gr2nting of a permit does not presume <br />to giva authority to violate or cancel the provision of any other state or local law regulating construction or the peRormance of <br />constructior�. That I am author;eeo by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 1827 RCW and 29620D WAC. <br />�� � � �� C.I c� �Jt� � y 26�� , <br />c ..............� ,......dr....�ronr.r/A���hndocrl Gnonf flata � <br />�L1-�rL�-YN FoNs <br />II <br />