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SITE ADDRESS <br />LOT NO. <br />A1 f At <br />PERMIT APPL��,A�TION <br />C,TY O� EVERETT PERMIT SERVtCES <br />3200 CEDAR STREET, EV[RETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE .4�CEPTED FROM 8 AM TO 4 PM <br />�x+:��..> PARCELTAXI.D.# <br />I:Ji -- — <br />BLOCK � I TRACT <br />,,. �)io C�>-.+� - U�' (},I� ,x -473 �>�, �.._,4 �3Y.��g <br />TENANT NPME �� � CONTACT FOR PERMIT I PHONE <br />I�JI,�- ��.(iT �175"��: � � 3•I i � <br />�-,n�l,,,.,.,-�.,� i-n�•.,, ��-,,. ,� :,G- .r., l l �. `�IJ''v_, hG%tili-I ii�17. j�i.' �� G�N . I�.lL <br />CONTRACTORJ �}'� �U,� e. <br />CONTR. LICENSE i <br />n� ecul e <br />USE OF BUILDING <br />;?. �' -1- /k( L� <br />x�.,t �� . 5i- . <br />v�e�� <br />� � ll - L � <br />�___ <br />SOURCE <br />_ Electric _ Gas _ Olher <br />WORK DESCRIPTION F/C',1+ �jk?(JCTUY2.GLC- -f f ' <br />1 <br />r��r�l:� �z� �e i� ,:ti,�,� a,+.�. <br />PLUMBING Cr,'�^.' <br />NO. I , TYPE OF FI%TURE OR ITEM <br />Toilet <br />5athtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry iray <br />Sink (service�admopletc.) <br />Backfluw preventer <br />Unnal <br />Drinking Foun�ain <br />Floor dra�n <br />Grease trap <br />Roof draics <br />Other <br />NO. <br />�CI ,rZP PHONE '��j3 - <br />I (�c�im(�..1�� �- _� C : • 1� C•�J <br />C��;�I�� i <br />��CONTRACT PRICE OF WORK <br />�1:����c�, <br />�2CGGY `c.Z�[�L'�'� CJ/iZC7� �c"lit.tc�� <br />MECHANIGAL j3>'jt' <br />TYPE OP FIX7URE OR ITFM <br />NC - air handling units <br />Forced air systems <br />Gas piGing <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstoee <br />CITY OF EVERETT LO�AL SALES TA% CODE IS 3105 <br />I hereby centi!y that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces goveming lhis type of work vrill be complied with whether specified herein or noL The granling of a pertnit does not presume <br />to give auihedry to violate or cancel the provision of any other e.tate or local Iaw regulating construction or the pedormance oF <br />construction. That I am authorized by the o�mei of ihis propert/ to perfortn the work tor whiGi appli�ation is made and I comply wilh the <br />State Contracturs Law �& R W and 296200 WAC. <br />Sw tur o�Wn /Contra iAuthonzed Agent � �at� <br />