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Nov.2�. 2C07 3:�i1f,11 42� �c� d962 <br />PERMIT �4PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320� CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FA:( 425-257-8857 —www.everettwa.org <br />'.:. :22� � <br />APPUCATIONS ARE ACCEPTED FROM 8 AM T04 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />S(IT]EADDRESS � 9FA� �m� I PARCEL7AXI.�.A PERMRp � <br />—I�O SECV�M1I3�T�AAM1 ��Y � )I�'�:, <br />LOT NO. � BLOCK I TRACT <br />� GESC.r I <br />CNRlER. " <br />� i_ GL7� 1�7 /� f, LL '' � <br />'. V�ov� n n� � �Cn�7 IMSIp n <br />TENANTNAM� <br />� <br />CONTACTFOR <br />PHONE <br />3 <br />f�. iTZ crtman� c_m�san- � J��•� �►+a� �I'zS -�02- z5 � s <br />LONTRACTOR ADDRESS <br />ru�a2�rntieutHN�cn� 9b3o t53�A�� A�Rcnn� ��1 �s-533�S2z� <br />coHTR uceHsea <br />USE OF BUILDING <br />WORK �ESCRIPTION }�D (� O N� <br />I� � wl Jrr'�- �j-a7�i9'afL— <br />E�6 w�s ld- <br />N0. I TYPE OF FlXTURE OR ITE1N <br />Toilet <br />Bathiub <br />Lavatcry (vrash basin) <br />Shawer <br />IGtchen sink 8 disposal <br />Dish�+asher <br />CloNes vrasher <br />laundry lray <br />Sink (service/barlmop/etc.) <br />Backfiow preventer <br />Urinal <br />Dnnking Fauntain <br />F!oor d2in <br />Grease t2p <br />Roal d2ins <br />Other <br />HEATSOURCE <br />_ ElecUic _ Gas _ Other <br />TRACT PRICE OF WORK <br />893� <br />�ufirtc7si �i�}� El z �a��s+�s O� <br />kt�10 /� S7irt-�- ow �lJ� F'J 2�.7 � SH+�i� 5�t N lL <br />• <br />N0. I TYPE OF FlXTURE OR REM <br />A/C—air hardling urits <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas 2nge <br />Clothes dryer <br />Ran9e hood <br />ExhaustSan <br />Heal pump <br />Unit healer <br />Boiler <br />Retngeration <br />Woodstove <br />aner <br />CI7Y OF EVERETT LOCAI SALES TAX CODE IS 3105 <br />I hereby ceMify that I hava read and examined this applintion and know Ne same to be irue and cortect. All provisions of Wvrs and <br />c�dinaces guveming tfiis type of vrork will be compl'ied wilh whelher specified herein or not The granting of a pertnil does not presume <br />to give authority to wolate or cancel Ihe provisian of any other state or lopl law regulaUng wnstruction or the per`ortnanca of <br />conswdion. That I am authorized byj�e owner of Ihis pmperty �o pedortn the wu�C ior which appiinlion is made and 1 comply with the <br />State Con redors Law 18.27 RCW a{(d(2�0� WAC. <br />r^� �� l ii_�Q •n � <br />