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�F___._._ _.. __ ' <br />I F'ERMIT APPLICATIO� <br />GITY OF EVERETT P�RMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />�i 425-257-88t0 - FAX 425-257-8857 - www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CAR�S ARE NOT ACCEPTED <br />SITE ADDRESS <br />I o Sc E�✓e <br />LEGAL LOT NO. <br />OESC. <br />�� PARCEL TAX I.D. N <br />2�0> �d�G3cCn� <br />TRACT <br />PERMIT # <br />, F'vevefi �cix'; l�.rrLrnc✓S I o Sio a1t ,�/� f��c l� -��a K� v k�a•+�, �..�1 4b'o3 3 <br />I 7ENANT NAME CONTACT FOR PERMIT PHONE <br />I Iian✓Aio S i�S ._ I �GIGIL�D� �%2S-7.CmS—/SG% <br />CONTRA�fOR A�DRESS FIN21P PJ{ONE <br />-t-„�e�w-Zo,.,n. $�g,.. Co /ay/y t�-.�y 94 �� �- E�vPiTC yzs-ws-isb"7 <br />CONTR. LICENSE # <br />USE OF BUILDING <br />�N. n.E�rC 1 �. 1 <br />WORK DESCRIPTION <br />�_ r� �T �/C�. Ll F�.1 � ♦ <br />HEAT SOUR�:E <br />_ Electric _ Gas _ Other <br />CONTRACT PR�CE OF WORK <br />/la � <br />�a�r�.�.� „„�.��.�l�a �..�� �wl�. � ��.�...-� l �Q-Nc�.S <br />(, �S ._ > <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bath:ub <br />Lavatory (vrash basin) <br />Sho�rer <br />Kitchen sink 8 disposal <br />Dishvrasher <br />Clothes vrasher <br />Laundry Uay <br />Sink (service/6admopletc.) <br />BacMlow preventer <br />Unnal <br />Drinitiny Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I NPE OF FICTURE OR ITEM <br />� <br />� <br />� <br />AIC-airhandlirW uniG <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas ra�ge <br />Clothes dryer <br />Rango hood <br />Exhaust fan <br />Heatpump <br />Unit heater <br />Bailer <br />ReErigeration <br />Woodstov� <br />Other , � <br />CIN OF EVERETT LOCAI SALES TAX CODE 15 7105 <br />. I hereby ceritify that I have read and examined thi , appliption and know the same to be We and corted. All provisions of laws and <br />ordinaces goveming this type of vrork vnll be complied u^:Lh whether specified herein or not. Tha granting of a pertnit does not presume <br />to give authori!y to violate or cancel the provision of any other state or local law regulating construction or Uia pertormance of <br />consVu That I am authorized by the ovmer of this property to perform ihe work tor whidi application is made and I comply wilh ffie <br />__ SFata Contra rs Law 18J�w'-R6�ll and 296200 WAC. <br />/ / / <br />�(�OS <br />