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PEFtMIT APPLIC/�TION <br />CITY OF EVERETT PERMIT SERVICES �� .p ,6 <br />3?_00 CEDAR STREET, EVERETT, WA 98201 �` <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />SiTE ADDRESS <br />s� er�E%T <br />LEGAL LOT NO. <br />DESC. <br />UWNER <br />��/N rt.0 �f, p �c717/ S <br />`% i,i r <,i7�9EN7.0 L�G <br />TENANT NAME <br />k^�>c��a✓ �tL ✓% cL€ <br />nAn ;: e n i , v � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />BLOCK <br />�C� sc cvF,�� rT ��AtcW.�y,A7 �12i-31'3 <br />R'� EUi/1c77 .0 L/� <br />CONTACT FOR PERMIT <br />�ur�tnl �rL <br />CONTRACTO � ADDRESS <br />s�N,�i�u, i�,�����T <br />CONTP.. LICENSE # /J/ �� s/1� � H fI O <br />/-�-u� -7 SS03 <br />USE OF BUILDING <br />�/.���7t� l�lcE�ry <br />WORK �JESCRIPTION <br />�� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wasl� basin) <br />Sho�ver <br />Kilchen sink & disposal <br />Dishwasher <br />Clotbes washer <br />Watc r healer <br />Sink (service/badmop/elcJ <br />Backflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />HEAT <br />� <br />✓ Eleclric _ Gas _ Other <br />PHONE <br />.�C/•-7%I -S'�d�J�T <br />PHONE <br />SC Zs—;3.s�3— ��do2 <br />CONTRACT PRICE OF WORK <br />.� !� DOO. br <br />� T <br />a� � -�� � �` � 7%�/.-�� , <br />mc�.nr�rvwr{� •� <br />NO. I TYPE OF F;KTURE OR ITEM � <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />Refrineration <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODF IS 3105 <br />I hereby ceritify thal I have read and examined lhis application and know lhe same lo be lrue and correct. AII provisions of laws and <br />ordinaces governing this lype of work will be complied wilh whether specified herein or not. l"he granling of a permit does not presume <br />to give authorily lo violace or cancel lhe provision of any olher stale or local law regulaling construction or the performance of <br />conslruclion. Thal{ am aulhorized by the owner of lhis property lo perform the work for which applicalion is made and I comply with lhe <br />Stale Contractors�Law 18.27 RCW and 296.200 WAC. <br />