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PEF.�VI17 APPLI�ATiO� <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 />SITE ADDRESS <br />6�.o E✓uefii <br />LEGA LOTNO. <br />DESC. <br />OWNER <br />$ct/en'fi+. a,ve Plaz <br />TENANTNAME <br />�SKo �fo� <br />CONTRACTOR ���,k <br />CONTR. LICENSE # <br />�er <br />USE OF BUILDING <br />Pro ��ts; o,w. I <br />WORK DESCRIPTION <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />( w_wY <br />BLOCK <br />PARCEL TAX I.D. # <br />z8os�gov�o� <br />TRACT <br />i��I'.dtP�a:t <br />�ia, 1 w Eve��f t�/a tP�o 432 1406' <br />FORPERMI PHONE <br />6C� iK lf �nt � <br />� N � _ p�DDFjESS <br />FI rd'�e,5p� �jreQ <br />`G2S= 77G-b'8�_ <br />CITriZIP PHONE <br />C�� kh f8.Z03 yZS- 776 <br />89 3,� <br />HEATSOURCE <br />��v'�lectric _ Gas _ Other <br />Sftc�( 2. Ca.firkel' Sl9�5 <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BalhWb <br />Levatory (wash basln) <br />Shower <br />Kitchen sink B disposal <br />Dishwasher <br />Ctothos washer <br />Water healer <br />Sink (service/bar/mop/otc.) <br />Backflow preventer <br />Urinal <br />Drinkir,g Fountain <br />Floor draln <br />Greasetrep <br />Roof drains <br />Olher _ <br />N0. <br />CONTRACT PRICE OF WORK <br />.L.� � �'S � , <br />TYPE OF FIXTURE OR ITEM <br />A/C — alr handling units <br />Forced alr systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clolhes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit h�,ater <br />Boller <br />Refrlgeralion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I heraby ceritify lhat I have read end examined this applicalion and know the same lo be true and correct. All provisions of laws <br />ordlnaces governfng this lype of work will be complied with whelher specifled herein or not. The granting of a permit does not pr <br />lo give aulhori lo violate or cancel lhe provlsion of eny other state or local law regulaNng conslrucllon or the performance of <br />construcllon. at I am euthorized by the owner of thls property lo perform lhe work for which appiication is made and I comply <br />State Contr o�r; Lav�.�8.27 R and 298.20D WAC. I��� ��� <br />r in � I li� � 1 � � <br />lhe i <br />