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P�RMIT APPLIC,�TIC,�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE'fT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org S—// �D� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />� 33v mti��o., <br />LEGA LOT NO. <br />; -� � v� <br />TENANTNAME <br />BLOCK I TRACT <br />CONTRACTOR J yy�G (p,� 5����,�Uh <br />CONTR. LICENSE # <br />J�Gcv <br />USE OF BUILDING <br />—Si ��—'c - <br />WORK DESC <br />s« <br />�TION �p <br />� (�i17��-C-. <br />�;��,���J 5�<<�� <br />l?30 <br />NO. I TYPE OF FIXTURE OR ITEM <br />2�Toilet <br />Bathtub <br />2�Lavatory (wash basin) <br />Shower <br />1 Kitchen sink & disposal <br />� Dishwasher <br />Clothes washer <br />Laundry tray <br />—'r Sink (service/bar/mop/etc.) <br />� BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />PARCEL TAX I.D. # <br />�ver�if `18zo3 <br />CONTACT FOR PERMIT <br />3ef� G: «.�.oHs e <br />ADDRESS <br />31oz Russ� II w,y <br />HEATSOURCE <br />_ Electnc � Gas _ Other <br />CITY2IP <br /># <br />PHONE <br />% <br />(2u6) z7G -135 3 <br />PHONE <br />Lynti�„�,�'' i�4o'y'7 (2�G) 27G- �353 <br />CONTRACT PRICE OF WORK <br />voo `=' <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling units <br />Forced air systems <br />Gas piping <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 />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3'105 <br />I hereby ceriti(y that I have read and ezamined this application and know the same to be true and correct All provisions of laws and <br />ordinaces governing this type of �vork will be complied with whether specified herein or not The granting oF a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am au[horized by the owner of lhis property ,o perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />3 2-0; <br />��� <br />