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` ___-�-- <br />PERMfT APPLfGA71ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - erww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM T� 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS , <br />�' <br />�-���i- i��ial`!� �� �J <br />LEGA LOi NO. <br />DESC. <br />,� <br />`�I i����.�� � '�r:`,��rl��� <br />TENANiNAME <br />� I <br />��„'�l�I �.'�u�, <br />BLOCK TRACT <br />CONTRACTOR�Ud:.IUI`i;�� _ <br />%/i <br />CONTR. LJCENSEA � ! <br />l <br />USF OF BUILDING <br />1� � <br />�'���1',�i� �� '�� ij _. <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />' I � ,!��� � jl(�l �,,\I.I{i� j'I!� ; <br />CONiACTFORPERMR � <br />ADORESS <br />l 1,�� S� <br />HEATSOURCE <br />_ Eleciric __ Gas _ Other <br />��i � � '� . � � � .� , ,,.. ��, <br />li'I�I f_e1� iii,�I Ii-j �jj � l• �'',I , 17� 1✓�It�l �'1' ll <br />PLUMBING <br />� NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />�� Bathtub <br />�� Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />I Clothes washcr <br />� LaunCy tray <br />� Sink (scrvicelbadmop/etc.) <br />Back9oH prcvcnter <br />Urinal <br />, Dnnking Fountain <br />Floor drain <br />� Grease trap <br />Roof drains <br />O!hcr <br />CITY2IP <br />PERMIT # <br />r�- <br />`i: ) i <br />:�i.�� i�� il;j:l� <br />��,�� <br />PHONE <br />��b� ��`i i�'�l) i <br />PHONE <br />GV Y 1 KAI.I rni�� ur r.un� <br />! <br />�� ��,i.! � � i <br />NO. TYPEOFFIXTUREORITEM <br />_ AIC — �Lr handling units <br />Forced air systems <br />Gas pipiny <br />Water heater <br />_ Gas fireplar.e <br />_ Gasrange <br />Clothes dryer <br />Range hood <br />Exbauslfan <br />_ Heat pump <br />Unit hcater <br />Boiler <br />Refrigeration <br />Waadstove <br />CITY O� EVERETT LOCAL SALES 7AX CODE IS 3105 <br />�, I hereby centify that I have read :�nd examined this appliration and know the same to be tn,e and correcL All provisions of laws and <br />'� ordinaces goveming this type of work will be complied with vfiether specified here:n or not The granling of a pertnit does not presume , <br />� to give au�honry lo violate or cancel the provision of any other state or local law regulating consW clion or the pertortnance ot � <br />' r,onsiruction. Tha� I am authorized by the ovm�of this property lo pedortn the work for which application is made and 1 compty wilh Ihe I <br />�, _Stete-Eontractnf` aw 1827 RC hd396.200 WAC. � <br />� �. 'i���_�,��_�, �. ��',. JUiF, <br />, _ ; - <br />_- - - - I <br />;i,� <br />�- - <br />