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<br />�f � PERMIT APPLICATIQN
<br /> ��i CITY OF EVERETT PERMIT SERV�CES
<br /> 3200 CEDAR STREET, F_VERETT, WA 9020'i
<br /> �� 425-257-8810- FAX 425-257-8857 -www.everettwa.org �
<br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ✓ � ��� I
<br /> i SITE ADDRESS PARCEL TAX 1�.# f�r �ERMITD�_ / I
<br /> c�.Z C� f L L 21�� �!-`d'�4 �3 0 J I �`� J J �^ �a
<br /> LEGAL LOTNO. BLOCK TRACT II
<br /> DESC.
<br /> "�' OWN � ADD S�s� � ,{�� � �CITYIZIP PHONE �./ j J;/
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<br /> �:B.R. HOLDR�iGS,LLC. �(i�-�J I�l'� -II� Wr, >>,i �: I:lu ���r6r {�Irll,{'�� �}�S �ii� 'e(:
<br /> {� '� I TENANTNAME CONTACTFORPERMIT PHONE
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<br />'';;� i �ci���cY ����I�sG4�ioey �J� wN /p�� ��V�'/✓ 4L�77j-2��1��
<br />,���� � CUNTRACTOR6CVAIJ �(,r"l'NCr1CZ.�NCY ADDRESS 7��j 33('c1 CITYIZIP PHONE
<br /> �; c�c. pc �,� m�ysv�l� yLS•�73-z64'�/ I
<br /> .t CONTR.LICENSE# �LVR�P.L��3rnY�'� �tfj��,�j()
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<br />� �t USE OF BUILDING HEAT SOl1RCE CONTRACT PRICE OF WORK j
<br /> (,Om�'le"72C��}t �C"N'n1'C. I _E!eclric _Gas�Olhe� �C'.UD(7 II
<br /> WORK DESCRIPTION �-
<br /> CpmM e�,'L l/fi� / � �2 O r%G lC C 5. i' WD �1/ckJ
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<br />�'��r.�, � O!'T l G[s //-� I T74"L ♦ ,
<br />'`�° � ' MECHANICAL
<br /> � , ; PLUMBING
<br /> �� �; NO. TYPE OF FI%TURE OR ITEM
<br /> q �. NO. TYPE OF FI%TURE GR ITEM
<br /> ��a•�' _
<br />�: �'�Y '� Toilel A/C-airhandlingunits II
<br />�a � - _ Bathlub _ Forced air syslems
<br />��;�,�. Lavatory(wash hasin) _ Gas piping
<br /> y t� �,, Shower Waler heater
<br /> �' Kilchen sink 8 disposal Gas fireplace �
<br />`I���� Dishwasher Gas range '
<br /> ' � Clothes dryer
<br /> - Clothes washer
<br /> � Laundry lrey _ Range hood i f ;
<br /> e� .;� I Sink(service/bar/mop/etc.) _ Exhauslfan =,�
<br /> -� � Backllow preventer _ Heal pump `��'
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<br /> Urinal _ Unit heater � a�
<br /> Drinking Fountain Boiler
<br /> Floor drain Refrigeralion
<br /> Grease�.ap Woodslove
<br /> Rocfdrains Olher
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<br /> CITY OF EVERETT LOCAL SALES TAX CODF IS 3105 c��
<br /> I hereby ceri�ify ihal I have read and exzmined Ihis application and know lhe same to be Irue and correcl. All provisions of laws and II i I
<br /> i;,�;,���`�� ordinaces goveming this type of work will be complied with whether specifed herein or noL The granting of a permit does not presume i �
<br />�'" to give authorily to violale or cancel lhe provision of any olher state or local law regulaling conslruclion or Ihe perfonnance cf
<br />�� conslruclion.That I am aulhorized by lhe owner oi Ihis properly lo perform the work for which application is made and 1 comply witn the �, ,
<br /> State Conlractors .27 RCW and 296.20D WAC.
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