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PERMIT APPLICATION �-- � ��� ^� D <br />CITY OF EVERETT PERMIT SERVICE �'-- -� �'� <br />3200 CEDAR STREET, EVERETT, WA 98201 � j; �.'_ ) <br />425-257-8810 — FAX 425-?_57-8857 — www.everethvs.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />qo� s�G c�E-n Mau. '^�ay <br />LOT NO. � BLOCK <br />AL <br />PARCEL TPJ( I.D. # <br />TRACT OR SUBDIVISION # <br />(pol Un�oN c.s�. SU\T� 53a�� <br />TENANT NAME CONTACT �OR PERMIT <br />���EST Co��.��-�� I E��zq Au-�N <br />--.......-•-•- ---- --- <br />l pE,� �- rN-rC-sz� o�s �o. PxX ��7 2�-. <br />CONTR. LICENSE # <br />iDEALLr02(vD� ��j,p��/� <br />USE OF BUILDING <br />O���c� - 6 <br />HEATSOURCE <br />l <br />PU��. _ „ �..h5 <br />r„�Nt (4zs� <br />wf� 3�5-��4 <br />PHONE 503 - 235 -v243 <br />E.MAIL ed@'�ni ki�,qa.�oci, <br />SEA'tf LE � WR --- CZo(y ) <br />� 81`l�l 94� - 434�Z <br />___ Electric _ Gas __ Other <br />CONTRACT PRICE OF WORK <br />� 38�oo0.�D <br />WORK DESCRIPTION n <br />New in+r�.iot� P�.-1;-%ioh wa�l(s � v�ew Pl��iz-icaY ��'�low.-�-e_ <br />ex�s-F;v� li��•t- -�'x-I-�Yes . <br />NO. � TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash�basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barlmop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust Fan <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Olher___ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and knnw the same lo be true and correct. All provisions ot laws and <br />ordinances governing this type of work will be complied wilh whetiier specified herein or not. The granting ot a pertnit does not presume <br />to give authority to violale or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296200 WAC. <br />//.la. io <br />Y� <br />Co�'h <br />