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�.' i 5 /� � <br />y�iS �3SS Sot� <br />��-��� <br />X-x-ti=� � � /c�i <br />� KaF��� n. C;'1��a�, <br />LOT NO. <br />DESC. <br />0 <br />� <br />U PERMIT APPLICATION <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l'�\ I I PARCEL TAX I.D. # <br />BLOCK � 1TRACi <br />PERMIT # <br />.�J�C1�1 'J1��Ci � � `F� b) �J%4f U K-C� ��1otTC �CQ lU. O � S � lC <br />TENANTNAME /CONTACTF RPERMIT PHONE /�L <br />C�.�fo{�� �I�C, CCci� �vi I � �1t4��c (��.Qc� � Fr��,v�ic� �Ll.l'� ��,1 zql <br />CONTRACTOR[.`�1��-�.��' � � ADDRESS���j�,�C`-lCf°�;1v`iS,CITY2IP ���� pHONE <br />lY,l'�vli.� , � �L(,� <br />if �oc' / <br />CONTR. LICENSE q�j �►—I �7 L L���� e�C� `� �; i i� 4 -- <br />USE OF BUILDING <br />('�_(.�� ��Q,wi.(S�v�� <br />HEATSOURCE <br />Electric _ Gas _ Other <br />WORK DESCRIPTION (�, • � <br />li`l �i�)iL� �up�('j�rY'�Stltt� $l.�!i��-,���rr.�i6-Q�, <br />B <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (service/barlmop/elc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Flocr drain <br />Grease trap <br />Roof drains <br />Other <br />t- 9� <br />I �-pU <br />;,LC� � . <br />1 � C L <br />CONTRACT FRICE OF WORK <br />� � �J L� � "a <br />N0. � TYPE OF FIXTURE OR ITEM <br />--�-- <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas ranye <br />Clothes dryer <br />�� Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Bciler <br />Refrigeration <br />_ Woodstove �. <br />_ OtherK-ID'Z, Ft��Q ,�ia.F,{;v�4`:`�„-'�'� <br />_ `� i }C)�'*,l� <br />CITY OF EVERE7T LOG1L SALES TAX CODE IS 3105 <br />I hereby centi(y that I have read and examined ihis application and know the same lo be true and wrrect. All provisions of laws and <br />ordinaces governing this type o( work vnll be complied with whether specifed herein or noL The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating conshuction or the performance of <br />consin.�ctwn. That I am authorized by the owner of lhis property to oerform the work for which application is made and I wmply with ihe <br />State Contractors Law 1827 RCW and 296.200 WAC. <br />�s�ttu o�R��:: ����,,,�.�'�����ti� � % � 1o�11���;L� <br />