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SITE ADDRESS <br />�Xv l5 l— c;. c <br />LEG9L LOT NO. <br />DESC <br />OWNE7 <br />�l.� i,� .'� �L�-1 <br />TENANT NAMET— <br />PERMIT APPLi�,ATION <br />CITY OF EVERE7T PERMIT SERVICES <br />3200 CEGAR 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 />PARCEL TA:( I.D. # <br />�Jt.�— `'��6 z-o 1 �jL US /`i� // !� u 7 G U <br />BLOCK TRACT <br />U4�,-��Gv'. �JC�' �7 <br />�� 7 1n <br />C <br />CONTRAC�OR • <br />(,�f�SN�/✓i'-%tJ% �V1}%d'/ <br />�L(1 t�'�z iLy <br />CONTR. LICENSE 71 _ _ , _ n <br />USE OF BUILDING <br />WORK DESCRIPTION <br />i_..�i�u�tl` G.�.[i" <br />�] <br />NO. <br />l �:. `-\ t �,'�YL�- <br />CONTACT FOR PERN,IT <br />r`l`��G\ <br />f �. � �- �d <br />PERMIT # <br />/,�� Ci) ; -- �- <br />Z�� ?L��. -U�l� <br />�6-✓ly-�v�.� �\J-"'-"�`�l-�-�� �37J�i �1��1�fj `���'JVu. <br />AOORESS 7. • � � <br />1�5J�° <br />_ Electric _ Gas _ Other <br />�� j l ��Cc;, ti�-t;L�C. /L� ��4�-� �, <br />iYPE OF FIX7URE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kikhen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/elc � <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />GITY/Z�P PHONE 4��Ln � <br />�,y�� lx „� %� s' yr�'i' <br />��'y?, =,Y <br />I CONTRACT PRICE OF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling uni�5 <br />Forced air sys�ems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range I iood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />i hereby ceritify �hal I have read and examineG this application and know the same to be true and correct. All provisions of laws and <br />ardinaces governing ihis type o( work will be complied with whether specified herein or not. The graaling of a permit dnes nol presume <br />to give authority to viola:e or cancel ihe provision of any other state or loral law regulating concVuction or the performance of <br />consiruclion. That I am aulhonzed by �he owner of this property �o perform the work for which application is made and I compty vnth the <br />State Contractors Law 1827 Rf,W and 296200 V+fAC. <br />