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PERMIT APPLICATION <br />CITY OF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, E'.'�RETf, 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 ADDRESS PARCEL TAX I.D. H <br />909 .5� EvtJRETT �LL ►^�a`( <br />s+� P�2� 2230518�0 <br />LEGAL LOT NO. i BLOCK TRACT OR SUBDIVISION # <br />9�'9 gvS�ness C�-le� ��C <br />TENANTNAME <br />f�dVu-r'�Cetl T�'a{{��C �7faci.uG�i-S <br />`75¢3 N6 1121�, �ve <br />CONTACT FOR PERMIT <br />Ge�4=, n�l-AfeWa•� <br />IT # <br />� ��in— <br />L'�vk�li.�d � Wh <br />PHONE �25 Sa I"�Z4�% <br />VVI�II�HIrW�f n ���Vu� �'nv��� <br />T�G MeChct�'1� Ca�� $8�1-0 IS2�� hVL NE ►�eL�ll�ahci <4-25-88 �-324'� <br />CONTR. LICENSE # w�} RBOSZ <br />T�� ��eiG �� �J� _. . -- <br />USE OF BUILDING <br />"I I '�- <br />HEATSOURCE <br />✓Electric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />4-�j �'�G � OC7 <br />WORK AESCRIPTION <br />��S�n�� A ,Sh(,�fi S�-j54e� AG ._ � Se�-tie.,� �.'a-a,-,-, . <br />NO. � NPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (service/bar/mop/etc.) <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas Ureplace <br />Gas rsnge <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woadstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinances governing this typ� of work will be complied with whether specified herein or not. The oranting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance oi <br />construction. That I am authorized by the owner of ihis property to perform the work tor which application is made and I comply with the <br />State Contrectors Law 18.27 RGW and 296.200 WAC. <br />6i�0i2oiO <br />