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SRE ADDRESS <br />Ia OZ <br />LEGA LOTNO. <br />PERII�IT APPL��ATI�,1N <br />CITY OF EVERETT PERM[T SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PIA <br />PAACEL TAX I.D. # /PEP,MIT #_ / <br />S� �c,rC� Y�?41� li�a� Z6 G S 1 YGU Ao � SDo /i� %%% � (�i <br />BLOCK TAACT 6Il SUBDIVISION R <br />SfEA�F�S"r Go. 4- <br />1.1E✓PoaT 3Epc�+, cp 92660 <br />n,�., e„� mzr,., iadcli�._ <br />TENANTNAME �J1j,�J���_ ���.v ' CONTACTFORPERMIT PFONE �Zn6) ,�S-99oy <br />� / <br />F_.O/aH GH�c�ST�ArVSo/a {�Erfi-2 lt1147%SorJ e-�.�a� hk�i�,5a�o��s; .+ E<r.�;/ <br />� • co.y� <br />J�t.S CowS-r�ewc.��ou 0575 l.v;tlows Qa RtcP�*,o-rd u.�/+ <br />CONTR.LICENSE# J�s _' � . 9so5 Z C425�- �gt-3Z62 <br />�i Qii 1.50 � ��I�L��4 (Z�� <br />11SE OF BUILDING <br />n'kY.�5u,5� �n�� U7H�vs <br />HEAT <br />_ Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />.� � ZO� Ofj() <br />WORK DESGRIPTION <br />TC�l4.,'(" Imp/b�>i.�Cn'f �i M.�4SG �n� oi;N�•c. in .�.�c�c� Mnl� <br />�vl�Gi� 1.✓/+. '�' 2i20 �ctu�.� �'c�" <br />NO. TYPE OF FlXTURE OR ITEM <br />� Toilet <br />�BatMub <br />Lavatory (wash basin) <br />_ ��hower <br />� Kilchen sink & disposal <br />Dishwasher <br />! Clothes�asher / <br />[ N�ater heater � <br />&nk (service % op/atc.) <br />_ backtlow pr�ve r <br />Urinal � <br />Drin�Fountain <br />_,� Flo drain <br />Grease trap � <br />ftoof drains <br />Other <br />NO. I TVPE OF FU(TURE OR R�#1 <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />s range � <br />Clo s dryer � <br />Range od <br />Exhaust(a <br />Heat pump � <br />Unit heaf� �_ <br />Olher <br />e t eS� a4 a� by «„f.�..�'a... <br />� <br />CITY OF EVERETT LOCAL SALES TAX COGE IS 3Y05 <br />I hereby ceritify tha9 I have read and examined this application and know ihe same to be lrue and correct. All piovisions of Iaws and <br />ordinaces governing this typs ot .vork will be complied with whether specitied herein or not. The grant�ng of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the perfortnance o( <br />conslruction. That I am aulhorized by ihe owner of this property to perform the work for which applica�ion is made and 1 comply wi[h the <br />Stale Cantract rs Law 1827 RCW and 296.200 WAC. <br />� rJ J �. n � __ <br />� -.�,t � �_�'-� <br />�,-a „� n:,.,o�ir,,.,r,���,,.in��in�.;��'n„o.,� --- n�:o � <br />��a <br />