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� <br />SITE ADDRESS '���� <br />��}'oL Gl.g. LV�zEti Nt <br />LEGAL LOT NO. <br />DESC. <br />—� <br />OWNER <br />TENANT NAME /J'-��� <br />% �v�a�rt <br />CONTRACTOR% %/�N nA� <br />l /6 I�w` <br />CONTR. LICENSE # � <br />USE OF BUILDING <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EV[RETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettv�a.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />' CoH�4ui�5 <br />'v�,L.L <br />cL/) N C` <br />�o Cou,er�,e-s�..u,�s,�j" <br />PARCEL TAX I.D. # PEj2iN1T # <br />r.� -71���_��rG� <br />TRACT <br />CONTACT FOR PERMII <br />AADDRESS <br />� <br />Co `7-7�� ��%S <br />HEATSOURCE <br />__ Elecliic _ Gas __ Olher <br />F� /� " "' <br />'✓. u ../ � <br />� .• ' <br />CONTRACT PRICE OF WORK <br />i,�o, aoo �o <br />WORK DESCRIPTION � r r � D�� C,ry�,� �Q�'j'Tfy��/'T Q���TT N%JbL� �D <br />T�n � �--� <br />Cou,tr <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />BalhWb <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dish�vasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/elc.) <br />Bar,k!low.preventer <br />Urinal \ <br />Urinking Fountain <br />Floor drain � <br />Grease trap �� <br />Roof drains �\ <br />O�hcr—_--�,— <br />NO. I TYPE OF FIXTURE OR �: EM <br />_ / A/C - air handling units <br />Forced air systoms <br />:—% Gas piping <br />� Water lieater <br />Gas freplace <br />_� �Gas range <br />Clothes dryer <br />Z Range hood <br />� Exhausl (an <br />_ Heatpump <br />_ Uni[ healei\ <br />Boiler <br />_� Refrigeration � <br />Woodstove <br />Olher <br />� CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby ceriti(y that I have read and examined this applicalion and know the sane lo ue true and correcl. All provisions of laws and <br />ordinaces goveming Ihis !ype o! work will be complied with whether specifed here�n or nol. The grz nting of a permit does not presume <br />to g�ve aulhoriry to violate or cancel the provision of any olher state or local law !egulating construrtion or lhe performance of <br />construclion. That I am authorized by the owner o( Ihis property to perTorm the woik for which a;,plicalion is made and I comply with the <br />Stafe Contradors L�18.�7 RCV)✓and 296200 WAC. <br />