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<br />;� , _- p��Mll' A�PL�CA1'IUnI �eevn !
<br /> ���� CITY OF EVERETT PERMIT SERVICES
<br /> Y n 3200 CEDAR STREET EVERETT, WA 98201
<br /> 425-257-8810- FAX 425-257-88E7-www.everettwa.org
<br />��� � n APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM
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<br /> SITE ADDRESS PARCEL TAX I.D.# I PERMIT#
<br />''`� ' oll �l,e,�ve ooc�oB�00000�oo �' 7//-j�/
<br />'r�F,�c'�i LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION#
<br /> I� ti�,' UESC. Q00 17-00
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<br /> �'. OWNER ADDRESS CITY/ZIP PHONE.1z� 7S�F_Z�7z
<br />�,��, ' S�EVEnI �akAl {.,/�nIDSYE,Qk C'c�n5f. LLC �315 ST2�31tnrUE �Z�l
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<br /> i;�x.._ TENANT NAME CONTACT FOR PERMIT PHONE
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<br /> �� i CONTRACTOR ADDRESS CITYIZIP PHONE
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<br /> CONTR.UCENSE#S TEVEfL I S$ KGL
<br /> USE OFBUILDING ( — HEAT SOURCE I CONTRACT PRICE OF WORK
<br /> �'j -�2 Electric �,Gas_Olher
<br /> WORK DESCRIPTION ,
<br /> �lC.�/.�
<br /> o� S�n� lc. -���,�,��,� s� �lev�ce
<br /> PLUMBING MECHANICAL
<br /> NO. TYPE OF FIXTURE OR ITEM NO. TYpE OF FIXTURE OR ITEN
<br /> _;S Toilel A/C—air handling unils
<br /> � Balhtub � porced air systems
<br /> Lava�ory(wash basin) Ges piping
<br /> Shower _L Waler heater
<br /> _1_ Kilchen sink&disposal f Gas fireplace
<br /> � Dishwasher � Gas range
<br /> � Clolhes washer � Clothes dryer
<br /> _¢+ Waler healer � Range hood
<br /> Sink(service/bar/mop/elc.) � Exhaust fan
<br /> _ Backflo�v preventer Heat pump
<br /> Urinal Unit heater
<br /> Drinking Fountain Boiler
<br /> _ Floordrain Refrigeralion
<br /> Grease irap Woodslove
<br /> Roof drains Other
<br /> Olher —
<br /> CITY OF EVERETT LOCAL SALES TAX C:ODE IS 3105
<br /> I heraby cerilify that I have read and examined this application and kno�v the same l�be true and currect. All provisions o(laws and
<br /> ord�naces c�overning this type of work will be complied with whether specified herein or not.The granting of a permit does not presume
<br /> to give aulhority lo violate or cancel the provision of any olher stale or local law regulating r,onstruction or the pedormance of
<br /> conslruction. t I am a prize by e owner ot this property to perform lhe work for which application is mado and I wmply with the
<br /> Slate Contr c rs Law 1 .2 R W a d'29G.200 WAC.
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