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P��RMIT APPLICATIC>�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT # <br />D�, sE Ev�crxt" sf� yGo�Y�p IB'ZS os3 o�soo os os -o a <br />LEGA LOTNO. BLOCK TRACT � <br />DESC. �� 7; U ��" <br />Ja.sut5 �F����✓' % Cellie�s <br />TENANTNAME <br />� hla.�bor Kowus <br />CONTRACTOR'r'�t� <br />V <br />CONTR. LICENSE # <br />USE OF BUILDING <br />�rr1� <br />WORK DESCRIPTION <br />M � Oio�tL G��[.! rioitl, <br />�IliXTS. <br />PLU <br />G SDD i(ciA�,60v f'f �5 <br />CONTACT FOR PERMIT <br />I/r�i .�at�pi L� CoKkclC <br />ADORESS <br />'��1� � � <br />HEATSOURCE <br />Electric Gas Other <br />CITY2IP <br />W� rnonr �„ p00 • <br />rs � �sf• /�ys <br />P ONE <br />2r�G7o •G'7o6 <br />• /o / <br />PHONE <br />CONTRACT PRICE OF WORK <br />�� �� <br />NEW T&A�,l�►/t� t��=LLS Fa� oCC7CE5 ��LocA-7b �rsT. <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wasli basin) <br />Shower <br />Kitchen sink 8 disposai <br />Dishwasher <br />Clothes washer <br />Laundry lray <br />Sink (service/badmop/etc.) <br />Backflow preventer <br />Urinai <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. � TYPE OF FIXTURE OR ITEM <br />fV(:— air hantlling units <br />'orced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Ciathes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and comect. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether �pecified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any olher siate or local law regulating construclion or the performance of <br />construction. That I am authorized by the owner of lhis property to perform lhe work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />