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PERMIT �►PPLICATI�iV <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 />SITE ADDRESS �7..p3 YYJ�j��. A� <br />LOTN�� �BLOCK <br />7J "'�' <br />PARCEL TAX I.D. # <br />j � <br />�//.1 �%�?. - � <br />P6�2MIT # <br />%n �' i <br />L_:> r__� <br />L?� �� � F ��1.: .� <br />OWMER AUUKhuD / �.ii��ur rnvnp�^��.�Zr,/' <br />\J..._. <br />W�5 s� A�tiB i4N�t 93'fZ N. ��otf� ��L• �ilcls�'P, $� �i85'743 _ <br />TENANT 4AME CONTACT FOR P[RMIT PHONE <br />�nl�ikK�T �1'trrl4tw�7, ��'� �'�' 3441 <br />CO(NTRACTOR <br />`�� <br />CONTR. LICENSE k <br />USE OF BUILDING <br />�1N�.� ����'i� <br />ADDRESS CITYIZIP <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />PHONE <br />CONTRACT PRICE OF WORK <br />���� 1�/,7r_!/ <br />WORK DESCRIPTION <br />roS'7o�rr-z�r-r o}� 6�/Sr�G� ��+ss � GR� • C.��ru-�.fcr- NEw 2- sT�.� <br />�Ih(oL� �"�`tm�V'i �51�7-ICrs W('r# ��t-�Ci �' Afif"L�C.�-1� �b� • <br />3� _� C,�= �1;,�1- /���� � <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilet lll/ <br />Bathtub // <br />Lavatory (wash basin) I�� <br />Shower / <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) /� % � <br />Back(low preventer <br />Urinal <br />Drin!cing Fountain <br />Floo; drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I 'fYFE OF FIXTURE OR ITEM <br />NC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood �t� <br />Exhaustfan !� i7� �/ <br />Fieal pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3'105 <br />�fy that I have read and examined this application anc; kncw ihe same to be true and correct. All provisions oF laws and <br />�erning this type of work will be complied with whether specified herein or not. The granling of a permit does not presume <br />�ity to violate or cancel the provision o� any oth=r state or local law regulating construction or Ihe peAormance of <br />That I am authorized by lhe owner of lhis properiy lo per(orm th ork fsr which application is made and I comply with the <br />�tors Law 1 W and'196.200 WAC. <br />( � ` � ,. . . '�2� <br />ner/ConlractodAu gent D `/ <br />'i -'� <br />�i �: � � � i <br />