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PERIIOIIT' APPLICATION <br />CITY OF EVEF:ETT PERMIT SEI�VICES <br />3200 CEDAR ��TREET, EVERETT, WA 98201 <br />425-257-8810 — FAX. 425-257-8857 — wvdw.everettwa.org <br />APPLICATIONS AR:E ACCEPTED FROM 8 AM TO 4 PM /Q �. Q�-`V <br />SITE ADDRESS <br />�l2�! H04�T <br />LEGAL LOTNO. BLOCK <br />�ESC. <br />OWNER <br />MA2G/� IZr1� LYM/� <br />TENANTNA E/ <br />4' <br />RACTOR <br />�uAu i �;' tz�� rNg <br />CONTR. UCENSE # ��4 L' � 2� / <br />�� <br />USE OF BUILDING <br />WORK DESCRIPTIOM1 <br />�Zc Pan�2 <br />I�LLCti(f3E2 5 <br />�'CA2 ��� <br />3 n rh iasT,� <br />�=cAs�a�N�S <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />BackAow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />PARCEL TAX I.D. # <br />TRP.CT OR SUBDIVISION p <br />ADDRESS <br />(J?�i NO�h AVE <br />ICONTACT FOR PEkM1T <br />ADDRES <br />�n, �x 2�28 <br />k <br />HEATSOURCE <br />_ Eleciric _ Gas _ Other <br />PERMIT ff <br />98ZG'I <br />PHONE <br />CV�2�%T q2�-3�LI3y5 <br />9gzr3 <br />CONT!?ACT PRICE OF WORK <br />t�� �Pt.AC� A-�� OAM�1aN�wlQ�2 v� <br />FE�r, 2�2oor-- �o yrz co�-rn, <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air hantlling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify thal I have read and examined this application and know the same to be true and correcl. All provisions of laws and <br />ordinances governing this type of work will 6e complied with whether specified herein or not. The granting of a permit does nol presume <br />to give authonty to violate or cancei the provision of any other state or local law regulating wnslruction or the per(ormance of <br />construction. Tha� I am authorized by lhe owner of this property to perform the work for which application is made and I comply with lhe <br />State Conl[ac�ors Law 18.27 RCW and 296.200 WAC. <br />