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� =RMIT APPLICAT► �N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE A�DRESS <br />� � ���,�t � <br />LEGAL LOT NO. <br />��,�,,�.4�e /�1�...LLe, <br />TENANTNAME <br />AA�.d ��7 <br />CONTR. LICENSE # <br />i �L��I C�Ge <br />Z�cc�ir,��Y��s .riie <br />'!'IUTG( ?I04� J. <br />USE OF BUILDING <br />,� -z . ,���,��,�` <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />�.Pb�'/ vv 30 . <br />TRACT OR SUBDIVISION # <br />�'��a, 6� s�a-+�,�e,r� <br />CONTACT FOR PERMIT <br />NVVM1GJJ <br />J�.3 z i7�'�.�- �t% <br />�'&�� , '?-+�� � <br />HEATSOURCE <br />_ Eleclric _ Gas _ Olher <br />Cv��.c�' ; ��vv,'oC LQ Q <br />��au�1D <br />PERMIT # <br />nn�ooq_ <br />PHONE ��] 66?-�7�� <br />E•MAIL L�12nQ �i V4�t A I�1i <br />�06- ��7-G�¢7 w <br />io� <br />20�—�/%6p �� <br />7c��h c�,- «�w� <br />�,��ci, io' T�/�� I ,��-�-o� �,� e.e,t67; <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Ba�htub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heatc�r <br />Sink (servicelbadmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />CO��TRACT PRICE OF WORK <br />Gi��vi�Gt�Ed�/�C% —.I Cy� <br />�i e��rz �na.�r�`� <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood � �p � T r�P�'�, <br />Exhaust fan � <br />Hea� pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify ihat I have read and examined Ihis application and know the same lo be lrue and correct. AII provisions of laws and <br />ordinances ;, �verning this lype of work will be complied wilh whether specified herein or not. The granting of a permit does not presume <br />to give authori�y to violate or cancel lhe provision of any olher slate or Iocal law regulating construction or lhe performance o� <br />consiruction. Thal I am aulhorized by the owner of ihis property to perform ihe work for which application is made and I comply with the <br />Sta�e Coniractors l.aw 18.27 RCW and 2�J6.200 WAC. <br />I�z <br />