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SITE ADDRE:iS <br />3,.�•9 t-(� <br />LEGA LOT NO. <br />DES� <br />P�RMIT APPLICATION <br />CIT1( OF EVEFiETT PERMIT SERVIGES <br />3200 CEDAR STREET, EVEREI7, WA 98201 <br />425-257-8810 - FNX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. 7! PERMIT # <br />�- rF�� voK��ri7Gs�iHoo (��,�7-�0,� <br />—r BLOCK TRACTORSUBDIVISIONIt <br />t+c��� I,�-c'_. Y.Ino4 N�•I�t�a (,au� r�(�K�i�ea `183-�5 <br />TENANT NMSE CGNTACT FOR PERMIT PHONE yZ5 �- `I 3l -W��I 7 <br />t�r5 KfM a��d Wc.lnw� fj�� Sc�-4�Ko e,�,�a� Ss}1«�'��,-tcRs�,NE <br />�— <br />I—�(.�\ il��•,b;n`1 � CcnS+rw..},c,� � 8cr� I'i`14+ �Nct�l<uttll a,, `1�c'y�, <br />CONTR.LICENSEp �o�Aly��eb�SJ'� `IZS``i�l-4��`17 <br />USE OF BUIl.01NG I HEAT SOURCE I CONTRACT PRICE OF WORK <br />_Eleclric _ .. Gas <br />WORKDESCRIPTIOM �N��.�.�� fa� �.��v�'NL��ni�1 ^�riA <br />� <br />RE�yoAcl. �'F nFN�'P'L c r6cc E. <br />TYPE OF FIXTURE OFi ITEM <br />Toilet <br />Bathlub <br />Lavatory (wash basi�) <br />Shower <br />Kilchen sink & dispo��al <br />Dish�.vasher <br />Clolhes washer <br />Waler healer <br />Sink (service/badmop/elc.) <br />Backllow prevenler <br />Urinal <br />Drinkinc� Foun�ain <br />Floor drain <br />Grease irap <br />Rool uains <br />ou,e� Mcd,z,+1 �as_cu{k�5 <br />Other I � fj(1 6pD <br />i <br />r�ea;�q� 6�s FoC'�- <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air sy5iems <br />Gas piping <br />. Water heater <br />__ Gas fireplaco <br />_ _ Gas range <br />_ _ Clothes dry�r <br />_ Rangehood <br />Exhaustfan <br />. _ Hea� purtip <br />Unii heater <br />Boiler <br />. Refrigeralion <br />Woodstove <br />Othet <br />CITV OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby cerildy that i have read and ezamined this app'calion and know Ihe same to be Irue and correct. All provisions ol laws and <br />ordinaces c�oveming Ihis rype ol work will be complied w!th whe�her specifieci herein or no�. The gran6np of a permit does nol presume <br />to give authority lo violate or cancel Ihe provisinn nl any o!her slale or local law regula�ing cons�mction or Ihe perlormance ol <br />constmction. Tha� I am authorized by Ihe owner ol this pioperty to perlorm U�e work lor which applicalion is made and I comply wiih Ihe <br />Sta�e Contractors Law 1827 FlCW and 296 200 WAC. <br />� � � �.'��' �7 " %- � �j <br />,..—...... _„�..__.,�__�.....�,..,..,.,�....:....� �,.,,.,. na�a <br />