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SITE ADDRESS <br />�/; UJ ��l <br />LEGAL LOT N0. <br />D[SC. <br />P��RMIT APPLICATIC,N <br />CITY OF EVERETT PEkMIT SEP.VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE .4CCEF"i �D FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />BLOCK � TRACT OR SUBDIVISION t! <br />PERMIT # <br />Cv�ll - <br />I�q ' � L. (\R`C i�Gi�%�i�7A �\1 \ r:U ' � -.'� ��ii`1— `�� -<• <br />TENANTNAME . � COIITAC�FORPERMIT PHONE �,.� �� ��.-�(� �,�, <br />V VI� I I�M� V I\ / q (,. <br />�\.il.��l �-l)j-1•�'l 1�/ `�NfiCf�OZ ` <br />CONTR. LICENSC- !! <br />US[ OF BUILDING <br />r (— <br />1 r � , A r <br />WORK DESCRIPTION <br />V�� <br />3�� <br />\ < 1 \� E-M17AIL <br />j GIIT/UY � Yt1VNt <br />%S3 �' S� � n�N�L,"`'�; `�4�-� <br />w��t� . � ��(�Z �� �� <br />HEAT SOURCE .CONTRACT PRICE OF WORK <br />��� �,c^C� <br />Eleclric Gas Olher � � �G' ` <br />>t����LL lai� os�� /��U�'� �en�vL'�4.� .1n,s�/�� <br />33 �I f �,�i : 3� , 3�� � <br />NO. I TYPL" OF FIXTUR[ Oft ITEM <br />Tailel <br />Balhlub <br />Lavatory (wash basin) <br />Shower <br />Ki(chen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Waler healer <br />Sink (service/bar/mop/eta) <br />Back(low prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grea,e irap <br />Roof drains <br />Olher <br />I�[�7 <br />Mt� <br />NPE OF FIXTURE OR ITEPd <br />A/C - air handling unils <br />Forced air systoms <br />Gas p�ping <br />Water heater <br />Gas f replace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausl(an <br />Heat pump <br />Unit heater <br />Bailer <br />Re(rigeration <br />Woodstove <br />CITY OF EVEnETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby ceritify Ihat I have read and examined this applica;�on and know the same ro be lrue and correcL All provisions o( la•�vs and <br />ordinaces geverninc� this rype of work �vill be cumplied �vith �ti�hether speci(ied herein or nol The granting of a permit does not presume <br />to give aulhority lo �.�iolale or cancel the provision o� any other stale or local law rec�ulalinc� construclion or the performance of <br />consiruclion. Th.at I am authorized by fhe owner of this properry to perform lhe work for K•hich application is made and I comply with lhe <br />Slate C,ontr�c'.ors La��18.27_RGNJ-And 296200 WAC. <br />,/ , r._� �/��,f n � <br />/i�,/, ��c.;�,.�t (. i/, l� % <br />