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PERMIT APPI�ICATIUN <br />C�T'Y OF EVCRETT PERMIT S�RVICES <br />3200 CEDAR STREET, EVERETT, WA 9�201 <br />425-257-8810 — FAX 425-257-8857 — �,vww.everei!wa.org <br />APf'LICATIONS AP.E ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />3��� N� tA��, ►�„z��Ti <br />LEGAL LOTNO. BLOCK <br />DESC. Z�-( }'ZS i `� <br />f L�"I C IV , LLC . <br />TEIJANT NAMe <br />"�� <br />PARCEL TAX I.Q. # PER�dIT # <br />Uuys'i�raizc�zNco � i Cil .��. <br />TRACT OR SUB�IVISION # <br />�=vi�<,xS-f'i�jj-uc��ti�tif�, �v.��efl-l/�%.�/'ye�Y <br />ADDRESS CITY/ZIP PHONE <br />�? U. Q�x ��k ��uv�I� �II E <br />CONTACT FOR PEP.MIT <br />Q�,,�l Rz��r,4iti <br />�nlrzj rn,ey <br />CONTR. LICENSE # R J� Z N L� 9� 3J F <br />USE OF BUILDING <br />Z �} l� /� (� v h c�� <br />, I.✓�. 9� Z 7� `/ ZS -�7v -s'oG�-s <br />-I`1l� va���.<< <br />(_GhGh��-f Lt/i <br />I1EAT SOURCE <br />_ Electric �Gas _ G�hcr <br />WORK DESCRIPTION (px Lu ��l U <br />pe,xv e,��ftrti� fFR - �7�;IdduP <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavalory (wash basir.) <br />Shower <br />,Kilchen sink 8 disposal <br />washer <br />Sink (se7�ia <br />BacY.flow {)4 <br />Urinal <br />Drinking Foi <br />Fluor drain <br />Grease Irap <br />Foot drains <br />Other __ <br />PHONE �/Zf-�"70 -I.S�32 <br />E•MAIL DTI� ZEG HULT�/ <br />YIZIP PHONE <br />�Zy2 �G� `7�;'-S9ol <br />CONTRACT P�:iCE OF 4VORK <br />3 Zo; o00 <br />MtG <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handli�g uni�s <br />2. Forced air sys�ems <br />�Gas piping <br />Water healer <br />_� Gas fireplace <br />2 $ range <br />2 C�;� sdryr.r <br />Z R� �ge od <br />� Exhaust fa <br />He�.l pump <br />Ur.it heater <br />Boiler <br />� Refrigerelion - <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALF.S TNC CODE IS 9105 <br />I hereby ceritify lh3t I have read ard examined this applicalion and know the same lo be true and correct. All provisions of laws and <br />ordinaces �uveminc� Ihis rype of work wif be complied with whether specified herein or not. The granting of a permit does not oresume <br />to yive authority to violate or cancel lhe provision of any other stale or local iaw regulating construction or lhe performance of <br />construclion. That I am authorized by Ihe owner of ihis property lo perform the �.vork for which application is made and I comply wi!h the <br />Stale Contraclors Law 1f1.27 RCW aod 29Fi.200 WAC. <br />�� <br />�^r , , � ��-�-�-E%G� �:_ � � Z `-/ — U,G <br />I/ <br />7 <br />