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PERMIT APPLICA�°IaN <br />C!TY QF EVERETT PERMIT SER1/ICES <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 />I SITE ADDRESS <br />� 321�j N���' cvr.-.r<w�_r; ��z.c� <br />, LEGA LOTNO. BLOCK <br />�i oESc. I D� 1 1 "�l � o <br />I�� OWNERGLlHT01J ntiC�(r_2S, �ll,.� <br />r,l(''�PKIuL 1 I Y GUn15i.S �-N�2� C�T, <br />IPARCELTAXI.D.# PERMIT# <br />G�437i�6�o�000 �('�(�OI'C;CI <br />TRACT OR SUBDIVISION A <br />c_ Jc�Pr:.-�^ PLAT <br />ADDRESS C(fYZP PHONE <br />� � �. � £,G Z53-Lo`1-53`i� <br />�ouG "� ow�l c.-1L� .t�'iA�atlA�Si'4'L�-� <br />TENANT NAME CONTACT FOR PERhCI <br />� r�o�� , I-ar-si��, �.wr:s <br />I <br />A qvunca� �� <br />P1�Jic1�iY c:O�S�., ;is �•.uc.,.. <br />CONTR. UCENSE iI L GO 1 F I R 5 i PC 9 Z.1 D 3 <br />USE OF BUILDING <br />S 1= i� <br />HEAT SOURCE <br />ZC Electric _ cas _ aner <br />PHONE �L5-3.S3-�Sil <br />E-Mal�.ir.�c�c� C'. t.�ci �y"� <br />� �Y.C' <br />CONTHAI:I YMIGtvrnvnn <br />%� l 0� aoc'� <br />i(,'1� Sri.Fr, i-{o�sc �'�- vI <br />WORK DESCRIPTION � � w s i A� t.. S� <br />��J�S1�1 �iL1=PAli� i'k�'vl(ii15LY STP2�C1=� R.-b\J�JE!- j�'= <br />v:uJUo«.�4, �Z(z��TJtt:3 To �-o�G� i�rGJI�T FRu!��; �or.U�l� DK.�!wPl.i-.Q�P <br />� SI;���C� RE-lus7i�ti i,,AiN�z,+1. c-lu�vn.r�s AS <br />US .=-D�'�.�Fik' ;.til-i=1C2 �.u�.. �'rchFi7 <br />...-... u <br />NO. I TYPE OF FlXTURE UR fTEM <br />I Toilet <br />_(_ BaihWb <br />� Lavatory (wash basin) <br />Shower <br />� Kilchen sink 8 disposal <br />Dishwasher <br />1 Clolhes washer <br />9% Waterhealer <br />Sink (service/bar/mop/olc.) <br />� Aackllow preventer <br />Urinal <br />Drinking Fountain <br />- Flocr drain <br />_ Grease trap <br />Root drains <br />Ofher __ <br />� I — ---- <br />p�p. I TYpE OF FI%TUHE OR REM <br />A/C - air har.dling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas freplace <br />Gas range <br />Cbthes dryer <br />Range hood <br />Exhaustfan <br />Neat pump <br />Unit hea�er <br />Boiler <br />Relrigeretion <br />Woodstove <br />CfTY OF EVEREff LOCAL SALES TAX CO�E IS 3105 <br />I hr.reby ceritiry ihat I have read and axamined this application and know the same lo be Irue and correcl. All provisions ol laws and <br />ordinaces goveming this �ype ol work will be compliod with whether specilied herein or not. The graniinq ot a permit does not presume <br />to give aulhoriry �o viola�e or cancel Ihe provision ol any olher slate a local law regulating consVuction nr Ihe padormanco ol <br />censiruction. That I am authonzed by tho owner of tliis propeAy to pe�forrtythe work br which applicatiai is made and I comply with ihe <br />State Con�rac�o�8.27 RCW and 296.200 WAC. <br />�7 C�-+, t-' - -� I% 1� /U <br />�r-,��,rJ LI �.)t:� <br />c c.�. <br />I <br />