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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />5�2� LUwC Il ��l <br />LEGAL LOT NO. BLOCK <br />/i� �O� n /'�"� K! n S <br />TENANTNAME / <br />SO.M2 0.j 0.bUJ� <br />PARCEL TAX I.D. # <br />Doy9< 80o Bo/Goo <br />TRACT OR SUBDIVISION iJ <br />�-�Zz Lowe l( i2� <br />CONTACT FOR PERMIT <br />PA-7 /��CL�njU✓� <br />L ve .� <br />curvircnc wn I ���n��� � <br />Se � ��'� ��Q PI..i..,..� i �q e Fi2w*i r q f � 6 1�l'l i �.y N+n ��o u <br />CONTR. LICENSE # I � � � <br />USE OF BUIL.DING <br />WORK DESCRIPTION <br />r��,� y� s <br />}'�.� V 41 [l L t <br />HEATSOURCE <br />Eleclric _ Gas _ Other <br />�,;P„',� ��� <br />� H �, � . <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />�alhtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water healer <br />Sink (service/ba•lmopletc.) <br />Backflow preventer <br />Urinal <br />Drinking Foun�ain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />O� <br />PHONE yz s-G Yo-z / 2 I <br />E•MAIL /��urrl �. ��o Cpy�,�Cno'�. v <br />> P ONE <br />w f� 9Kd 3� `/� s-G Ya •,� /2 <br />CONTRACT PRICE OF WORk <br />o� <br />350 — <br />he �� h.e 1*✓ �o c a�:ar� -f-n <br />� <br />TYPE OF FIXTURE OR ITEM <br />A/C - air handling unils <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gasrange <br />Cbthes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woadslove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify thal I have read and examined this application and know the same to be true and correcL All provisions of laws and <br />ordinaces c�ovenung this lyp^ of work will be complied wilh whelher specified herein or noL The granting of a permil does not presume <br />to give authority to violate or cancel the provision of any other stale or �ocal law regulating construction or the perlormance of <br />conslruclion. Thal I am authorized by the owner o( this property to perform Ihe work for which application is made and I comply with the <br />Sta�e Co Ir tors Law 18.27 RCW and 296.200 WAC. <br />� %� - //- U d� <br />'/7 n , , e ( �l.L..�—, 6 <br />