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NERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32Q0 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 />SITE ADDRESS <br />sdrG M.4�ison. S� <br />LEGA LOTNO. BLOCK <br />�AC��t C'JUi✓7�j �¢�,.�Si . <br />TENANTNAME I <br />,P-0.g�n-LSUN i��-mCc iw.�L <br />corrra. uce��se a _ _ <br />Z7LL <br />USE OF BUILDING <br />Sr2 <br />WORK DESCRIPTION <br />PARCEL TA% I.D. # <br />TRACT OR SUBL.`IISION p <br />ADOfiESS <br />/�v l�Ox i30`f <br />CONTACT FOfl PEflMR <br />1�133u i2�-Fnl <br />$ ✓r= ,.i� <br />HEAT SOURCE <br />_ Electric _ Gas <br />inJ�ST-��c ��2t SP2�/✓:ece72S' /.v <br />NO. I TYPE OF FlXTURE OR ITEM <br />TOilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Flaor drein <br />Grease trap <br />Roof drains <br />(hher <br />Mf1.Qv5✓ic�c �6J�YSY'S-�3, <br />A/2uti��z�.✓ ...sE�v Yo3 �ubZ <br />`�� 2z 3 <br />Olher <br />�tJC�i <br />CONTRACT PRICE OF W�RK <br />,� 3yzo <br />S r ,2 <br />NO. � NPE OF FIXTURE OR REM <br />A/C — air handling uniU <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplacs <br />Gas range <br />Clmhes dryer <br />Range hood <br />Exhaustlan <br />Heat pump <br />Unit heater <br />Boiler <br />Relrigeration <br />Woodstove <br />S �.�Kcc.��. /�ic�-iiS <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby ceriG(y that I have read and examined this application and know the same to be true and cortect. All provisions ol laws and <br />ordinaces gaveming this type of work will be complied with whalher specified herein or not. The granting of a permit does not presume <br />to give authority lo violate or cancel tho provision of any other state or la;al law regulating consVuaion or the peAormance of <br />construction. That I am authorized by the owner of this properry to perlorm ihe work for which application is made and I comply with the <br />State Coniractors Law 1827,RCW and 296.200 WAC. <br />