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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRE�CT, EVERETT, WA 9820t <br />425-257-8810 — FAX 475-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />Z3ol �p`(TAYE.. EVEx;ETT <br />L =GAL ' ^T P:"v BLOCK <br />D25C. �..L. lu�a �(t�)AQ-12 4'8� n�00 <br />PARCEL TAX I.C. # <br />pU�}391 �489 00100 <br />TRACT OR SUBDIVISION # <br />TRINIT`/ c5�l�oYAL G�4J (�tl � 23oi �p+1TAYE. , <br />TENANTNAME <br />ONNE R. � K /�1 �n,•,- <br />--� CONTACT FOR PERMIT <br />(t�-�►������� L�,;��� <br />CONTR. LiCENSE tt �� i�_�-• ��G�/t,1 i.,- fr'�Y" 't_ <br />USE OF BUILDING <br />RF�_ir�ia�s a�ciivlr��s <br />E.VERE1� , 9 6 201-2 81� <br />PHOI:E <br />HEATSOURCE <br />Eleciric X_ Gas _ Other <br />! "]. — a—`7'-�� � <br /># GI Z <br />_ �r2i� <br />925 • 't8� <br />'F+-� c,�U % ' (o Z `{. " <br />�2�77 <br />�unue <br />��� t� 4�n s�-irp:r<<o�..!, <br />CON I HAG � rnice vr w�nn <br />� 150, O�'o �'� <br />WORK DESCRIPTION l,�K�1{u-�j� EXtsT�N(a 'SCCru�"�UYCE � lN6iA1.�.h��flN 0� �NL•T��N�S� <br />El2t�Tl�^ o� `�-tYZU�T�RI}� 5(�Z. �TFoRtri� INx�v9wcK�Nw -r�Nf.xt'iltlt,t(a� w000 <br />FR�►Nt111(a � R�'1e'�.'t�PMR.'� �`�'�D TCz�Yr. �- P�,�N'i'�t,ty. <br />— PL'JMBING <br />N0. I TYPE OF FIXTURE OR ITEM <br />Tailet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />� Cloihes washer <br />Water healer <br />�ink (service'banmopietc.) <br />BacMlow preventer <br />Urinal <br />Orinking Fountain <br />Floor drain <br />Crease trap <br />F;oof drains <br />Other _ <br />N0. I TYPE OF FI%TURE OR ITEIA <br />A�C - air hantlling un��s <br />Porced air systems <br />Gas piping <br />water heater <br />Gas hreplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausttan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigerabon <br />YJoodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODF. IS 3105 <br />I hereby ceritify ihat I have read and examined this application and know the same to be true and correct. All provisions ot laws and <br />ordinaces governing this type of work will be complietl with whether specitied herein or not. The granting of a permil does not presume <br />to give authority to violale or cancel the provision ot any other state or local law regulating construction or ihe peAormance of <br />construclion. That I am authorized by tye owner of this property to peAorm ihe work lor which application is made and I comply with the <br />State Contractors Law t827 RC1N and 296.200 WAC. <br />SignaWre ot OwneuContractorAuthorized Agent Da�e <br />�� <br />